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Date Printed: April 19, 2015: 03:02 PM

WHAT’S NEW

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4/15/15

New MCGs:

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  1. Nivolumab (Opdivo®)

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Reviewed and Revised MCGs:

  1. Abiraterone Acetate (Zytiga™) Tablet - Review and revision to guideline; consisting of description section, position statement to include continuation criteria, dosage/administration, definitions, and references.
  2. Ado-trastuzumab emtansine (Kadcyla™) - Review and revision to guideline; consisting of description, position statement, program exceptions, dosage/administration, references.
  3. Analysis of Human DNA in Stool Samples as a Technique for Colorectal Cancer Screening - Annual review; position statement maintained; program exception and references updated.
  4. Cabazitaxel (Jevtana®) Injection - Review and revision to guideline; consisting of description, position statement, related guidelines, and updating of references.
  5. Computed Tomography (CT) Thorax (Chest) - Revised description. Deleted pulmonary embolism and pre-operative evaluation. Revised: tumor, cancer or mass, infection or inflammatory disease, vascular disease, congenital abnormalities, hemoptysis, post-operative evaluation and add “procedural” to header, and other. Added: indication for combination studies for initial pre-therapy staging of cancer, or ongoing tumor/cancer surveillance, or evaluation of suspected metastases, combination studies with chest CT, and combination of studies with chest CT/sinus CT.
  6. Docetaxel (Taxotere®) IV - Review and revision to guideline; consisting of position statement, references, coding.
  7. Endovascular Procedures for Intracranial Arterial Disease (Atherosclerosis and Aneurysms) and Extracranial Vertebral Artery Disease - Revision; position statement, title, description, coding, and references updated; formatting changes.
  8. Enzalutamide (Xtandi®) Capsules - Review and revision to guideline; consisting of description section, dosage/administration, definitions, and references.
  9. Eribulin Mesylate (Halaven®) Injection - Review and revision to guideline; consisting of program exceptions, references.
  10. Extracranial Carotid Angioplasty Stenting - Review; position statements maintained; coding (codes 0075T-0076T removed) and references updated.
  11. Lapatinib (Tykerb®) Tablets - Review and revision to guideline; consisting of position statement, dosage/administration, program exceptions, references.
  12. Magnetic Resonance Angiography (MRA) Abdomen and Pelvis - Annual review. No change to position statement. Revised description and updated references.
  13. Magnetic Resonance Angiography (MRA) Brain (Head) - Annual review. Revised description. Revised indication for pre-operative evaluation (brain/skull). Updated references.
  14. Magnetic Resonance Angiography (MRA) Chest - Annual review. Revised description and position statement. Updated references.
  15. Magnetic Resonance Angiography (MRA) Extremity (Upper and Lower) - Annual review. Revised description and position statement. Updated references.
  16. Magnetic Resonance Angiography (MRA) Neck - Annual review. Revised description and indication for pre-operative evaluation (brain/skull). Added indications for combination studies (Neck/Brain MRA and Neck MRA/Brain MRI). Updated references.
  17. Magnetic Resonance Angiography (MRA) Spinal Canal - Annual review. No change to position statement. Revised description and updated references.
  18. Mechanical Stretching Devices for Treatment of Joint Stiffness and Contractures - Review; position statement and references updated.
  19. Non-Invasive Electrical Bone Growth Stimulators (EBGS) - Scheduled review. Revised description, position statement, and definitions. Updated references and reformatted guideline.
  20. Oscillatory Devices for the Treatment of Cystic Fibrosis and Other Respiratory Disorders - Revision; Position statement, description, and references updated; formatting changes.
  21. Pertuzumab (Perjeta™) Injection - Review and revision to guideline; consisting of revising position statement, references, definitions, program exceptions.
  22. Preventive Services - Revision; revised statement for chlamydia screening (women), dental caries, gonorrhea screening (women), and sexually transmitted infection counseling. Added statement regarding application of fluoride varnish to infants and children teeth. Added 87624, 87625, and 99188. Revised headers for dental caries prevention and healthy diet counseling. Added heading and statement for healthy diet and physical counseling to prevent cardiovascular disease (adults with cardiovascular risk factors). Added statement for preeclampsia prevention (aspirin). Added related guidelines. Updated references.
  23. Radium Ra 223 (Xofigo®) Injection - Review and revision to guideline; consisting of description, dosage/administration, HCPCS coding, and references.
  24. Sequencing-Based Trisomy Testing - Annual review; position statements and references updated; formatting changes.
  25. Sipuleucel-T (Provenge®) - Review and revision to guideline; consisting of description, precautions, program exceptions, and references.
  26. Trastuzumab (Herceptin®) Injection - Review and revision to guideline; consisting of description, position statement, coding, references, program exceptions.
  27. Urine Drug Testing in Pain Management and Substance Abuse Treatment - Review; position statements maintained, guideline title, reimbursement section and references updated.

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4/1/15

New MCGs:

  1. Levoleucovorin (Fusilev®) IV
  2. Olaparib (Lynparza TM)
  3. Palbociclib (Ibrance TM)
  4. Tiopronin (Thiola®) Tablet

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Reviewed and Revised MCGs:

  1. Antihemophilic Agents - Quarterly HCPCS update; added HCPCS code Q9975.
  2. Hepatitis C Drug Therapy - Revision to guideline; consisting of position statement, dosage/administration, precautions/warnings.
  3. Hereditary Angioedema Drug Therapy - Quarterly HCPCS coding update: added code C9445 and deleted C9399.
  4. Viscosupplementation, Hyaluronan Injections (e.g. Synvisc®) - Revision to guideline; consisting of changing position statement.

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Date Printed: April 19, 2015: 03:02 PM