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Date Printed: June 25, 2017: 01:20 PM

WHAT’S NEW

6/15/17

New MCGs:

1. Brodalumab (Siliq®) Injection

2. Deflazacort (Emflaza)

3. Dupilumab (Dupixent) Injection

4. Ergotamine (Ergomar)

5. Extracorporeal Membrane Oxygenation (ECMO) for Adult Conditions

6. Niraparib (Zejula®) Capsule

7. Ocrelizumab (Ocrevus®) Infusion

8. Ribociclib (Kisqali®)

Revised MCGs:

1. Abatacept (Orencia®) - Revision to guideline consisting of updating description section, position statement, dosage/administration section, and references based on expanded FDA-approval of JIA indication to age 2 years of age and older and new SQ dosage recommendations for JIA.

2. Bariatric Surgery - Scheduled review. Revised description section. Added coverage statement (E/I) for aspiration therapy. Updated references.

3. Computerized Dynamic Posturography - Review; no change in position statement. Updated references.

4. Deep Brain Stimulation and Responsive Neurostimulation - Revision; position statement and references updated.

5. Drugs and Biologics without Medical Coverage Guideline - Revision of guideline; consisting of addming Bavencio and Xermelo to Position Statement.

6. Erythropoiesis Stimulating Agents - Review and revision to guideline; consisting of updating the position statement and references.

7. Fosaprepitant (Emend®) Injection - Review and revision to guideline consisting of updating position statement and references.

8. Genetic Testing - Revision; Position statement section updated including CADASIL Syndrome position statements added and genetic testing for Alzheimer Disease position statement revised; references updated.

9. Granulocyte Colony Stimulating Factors - Review and revision to guideline; consisting of updating position statement, coding and references.

10. Ivacaftor (Kalydeco™) Oral - Review and revision to guideline; consisting of updating references.

11. Lanreotide (Somatuline® Depot) Injection - Review and revision to guideline consisting of updating the position statement and references.

12. Lenalidomide (Revlimid®) - Revision to guideline consisting of updating the description, position statement, billing/coding, and references based on an update to the NCCN guideline for CLL/SLL regarding lenalidomide maintenance treatment.

13. Lumacaftor Ivacaftor (Orkambi TM) Capsule - Review and revision to guideline; consisting of updating references.

14. Measurement of Apolipoprotein B (apo B) and Apolipoprotein E (apo E) in Risk Assessment and Management of Cardiovascular Disease - Revision; Investigational position maintainted; guideline title, description, position statement, and references updated.

15. Octreotide Acetate (Sandostatin LAR® Depot) Injection - Review and revision to guideline consisting of updating position statement and references.

16. Palivizumab (Synagis®) - Review and revision to guideline; consisting of updating description and references.

17. Platelet-Derived Growth Factors and Autologous Blood-Derived Preparations (Platelet-Rich Plasma) - Revision; Guideline title, position statements, coding, and references updated.

18. Preventive Services - Revised “blood screening: adults”. Deleted high blood pressure in adults: screening. Added USPSTF recommendation for preeclampsia: screening. Revised women’s preventive service; screening for gestational diabetes and breastfeeding support, supplies, and counseling. Updated references.

19. Prosthetic Eyes and Lens Implants - Review; no change to position statement. Updated description, program exception and references.

20. Psoralens with Ultraviolet A (PUVA) Therapy - Revision; title, description, position statements, coding, and references updated.

21. Siltuximab (Sylvant™) Injection - Review and revision to guideline consisting of updating references.

22. Spinal Cord Stimulation - Revision; High-frequency spinal cord stimulation added to position statements; investigational statement for wireless injectable dorsal root ganglion neurostimulation added; description section and references updated.

23. Tetrabenazine (Xenazine) and Deutetrabenazine (Austedo) - Review and revision to guideline; consisting of revising position statement and updating dosing, warnings/precautions and references.

24. Tumor/Genetic Markers - Revision; test names added to Biochemical Markers of Alzheimer’s Disease & Circulating Tumor DNA position statements section; investigational test list updated.

25. Vascular Endothelial Growth Factor Inhibitors for Ocular Neovascularization - Revision to guideline consisting of updates to the position statement, description section, dosage/administration, billing/coding, and references based on a new FDA-approved indication for ranibizumab (Lucentis).

26. Venetoclax (Venclexta®) Tablet – Revision to guideline consisting of updating the description section, position statement, and references based on updated NCCN guideline for CLL/SLL.



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Date Printed: June 25, 2017: 01:20 PM