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Medical Policy Update for April 16, 2025
| Medical Guidelines | Reason for Update |
|---|---|
| Ablative Techniques for the Myolysis of Uterine Fibroids | References added. Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director review 3/2025. No change to policy statement. |
| Bone Mineral Density Studies | Replaced “patient” with “individual” throughout policy. Policy Guidelines updated. References updated. Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director review 3/2025. No change to Policy statement. |
| Bronchial Thermoplasty | Minor edits throughout policy. References updated. Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director review 3/2025. No change to policy statement. |
| Convection-Enhanced Delivery of Therapeutic Agents to the Brain | Specialty Matched Consultant Advisory Panel review 3/2025. Updated and added references. No change to policy statement. |
| Cord Blood as a Source of Stem Cells | Specialty Matched Consultant Advisory Panel review 3/2025. References added. |
| Electromagnetic Navigation Bronchoscopy | Description, Policy Guidelines, and References updated. Updated “patient” to “individual” where applicable throughout policy. Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director review 3/2025. No change to policy statement. |
| Endobronchial Valves | Description, Policy Guidelines, and References updated. Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director review 3/2025. No change to policy statement. |
| Heart-Lung Transplantation | Description and Policy Guidelines updated. References added. Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director review 3/2025. No change to policy statement. |
| Hormone Pellet Implantation for Treatment of Menopause Related Symptoms | Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director Review 3/2025. References updated. No change to policy statement. |
| Infertility Diagnosis and Treatment – B0006 | Updated link in Policy Guidelines to reflect updated version of current guidance on the limits to the number of embryos to transfer. References updated. Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director review 3/2025. No change to policy statement. |
| Lung and Lobar Lung Transplantation | Description and Policy Guidelines updated. References added. Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director review 3/2025. No change to policy statement. |
| Lung Volume Reduction Surgery | Description and Policy Guidelines updated. References added. Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director review 3/2025. No change to policy statement. |
| Maternal and Fetal Diagnostics | References updated. Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director review 3/2025. No change to policy statement. |
| Monoclonal Antibody Imaging for Prostate Cancer | Specialty Matched Consultant Advisory Panel review 3/2025. References added. |
| Noninvasive Respiratory Assist Devices | Updated “patient” to “individual” where applicable throughout policy. References added. Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director review 3/2025. No change to policy statement. |
| Oncologic Applications of Photodynamic Therapy, Including Barrett’s Esophagus | Specialty Matched Consultant Advisory Panel review 3/2025. References added. |
| Oscillatory Devices for the Treatment of Respiratory Conditions | Minor updates to Policy Guidelines. References added. Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director review 3/2025. No changes to policy statement. |
| Ovarian and Internal Iliac Vein Embolization, Ablation and Sclerotherapy | Description and Policy Guidelines updated. References added. Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director Review 3/2025. No change to policy statement. |
| Phrenic Nerve Stimulation for Central Sleep Apnea | Description and Regulatory Status updated. References added. Specialty Matched Consultant Advisory Panel 3/2025. Medical Director review 3/2024. No changes to policy statement. |
| Sleep Apnea: Diagnosis and Medical Management | Description updated. Updated “patient” to “individual” where applicable throughout policy. References added. Specialty Matched Consultant Advisory Panel Review 3/2025. Medical Director Review 3/2025. No change to policy statement. |
| Surgery for Obstructive Sleep Apnea and Upper Airway Resistance Syndrome | References added. Specialty Matched Consultant Advisory Panel review 3/2025. Medical Director review 3/2025. No change to policy statement. |
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