| Medical Guidelines | Reason for Update |
|---|---|
| Diagnosis of Vaginitis including Multi-target PCR Testing AHS – M2057 | Reviewed by Avalon 1st Quarter 2023 CAB. Medical Director review 4/2023. Description, Policy Guidelines, and Reference section updated. Related policies removed. When covered section updated to add “Reimbursement of NAAT specific to the diagnosis of BV (e.g., Aptima® BV; OneSwab® BV Panel PCR with Lactobacillus Profiling by qPCR; SureSwab® Advanced BV, TMA) and single or multitarget PCR testing is allowed in individuals with symptoms of bacterial vaginosis (BV), for the diagnosis of bacterial vaginosis.” When not covered section updated to add “Reimbursement is not allowed for NAAT panel testing designed to detect more than one type of vaginitis (VVC, BV, and/or trichomoniasis; e.g., BD MAX™ Vaginal Panel, NuSwab® VG, Xpert® Xpress MVP).” Remaining coverage criteria updated for clarity. |
| Remote Therapeutic and Physiologic Monitoring | New policy developed. BCBSNC will provide coverage for Remote Therapeutic and Physiologic Monitoring when it is determined to be medically necessary because the medical criteria and guidelines are met. Medical Director Review 2/2023. Notification given 2/7/2023 for effective date 4/18/2023. |
| Urinary Tumor Markers for Bladder Cancer AHS – G2125 | Added new codes 0365U, 0366U, 0367U to Billing/Coding section for effective date 4/1/2023. |
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