Upcoming Medical Policies
BlueCross BlueShield of Tennessee

Each medical policy listed below will become effective on the date indicated, and will be included in the Medical Policy Manual for BlueCross BlueShield of Tennessee on that effective date.

Medical policies are developed using an evidence-based evaluation process.  The medical evidence used in this process comes from several sources, including independent medical technology review organizations, the peer reviewed medical literature, and opinions from appropriate network specialists. All Medical Policies are reviewed by a panel of internal and external physicians before being adopted by the company.

Topics due to be included in the Medical Policy Manual on 8/8/15

Topics due to be included in the Medical Policy Manual on 8/19/15

Topics due to be included in the Medical Policy Manual on 9/13/15

Topics due to be included in the Medical Policy Manual on 9/16/15

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Topics due to be included in the Medical Policy Manual on 8/8/2015:

Ablation Procedure for Peripheral Neuromas

Intravenous Immune Globulin (IVIG) Therapy

Measurement of Serum Antibodies to Infliximab and Adalimumab

Powered Exoskeleton for Ambulation in Individuals with Lower-Limb Disabilities

Topics due to be included in the Medical Policy Manual on 8/19/2015:

Ramucirumab

Topics due to be included in the Medical Policy Manual on 9/13/2015:

Artificial Pancreas System Device

Pharmacogenetic Testing for Pain Management

Positron Emission Testing (PET) for Oncologic Applications

Topics due to be included in the Medical Policy Manual on 9/16/2015:

Obinutuzumab

Tbo-Filgrastim

Transcranial Magnetic Stimulation, Cranial Electrotherapy Stimulation and Navigated Transcranial Magnetic Stimulation


Last Review Date 7/16/2015

Medical Policy Comments:

Please reference the policy name in your comments.
To submit comments about the upcoming Medical policies:
Click the “Medical Policy Comments” above or click here: Comments or Feedback.

Comments can also be mailed to:

BlueCross BlueShield of Tennessee
Medical Policy
1 Cameron Hill Circle
Chattanooga, TN 37402