| Medical Guidelines | Reason for Update |
|---|---|
| Leadless Cardiac Pacemakers | Policy Guidelines and References updated. Updates to When Covered section: removed "The Micra" and replaced with "Single chamber (right ventricular)", statement now reads "Single chamber (right ventricular) transcatheter pacing systems may be considered medically necessary in individuals when both conditions below are met..." Updates to the Not Covered section: removed "The Micra" and replaced with "Single chamber (right ventricular)", statement now reads "Single chamber (right ventricular) transcatheter pacing systems are considered investigational in all other situations in which the above criteria are not met." Removed "The Aveir™" from coverage criteria and statement now reads "Right atrial single chamber transcatheter pacing systems are considered investigational for all indications." Removed "The Aveir™ DR" from coverage criteria and statement now reads "Dual chamber transcatheter pacing systems are considered investigational for all indications." Specialty Matched Consultant Advisory Panel review 6/2025. Medical Director review 6/2025. |
| Paraspinal Surface Electromyography (SEMG) | Policy archived. |
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
Information in other languages: Español 中文 Tiếng Việt 한국어 Français العَرَبِيَّة Hmoob ру́сский Tagalog ગુજરાતી ភាសាខ្មែរ Deutsch हिन्दी ລາວ 日本語
© 2025 Blue Cross and Blue Shield of North Carolina. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. All other marks and names are property of their respective owners. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association.