Print

Date Printed: May 24, 2018: 11:40 AM

WHAT’S NEW

5/15/18

New MCGs:

1. Magnetic Resonance Imaging (MRI) Chest (Thorax)

2. Computed Tomography (CT) Heart

Revised MCGs:

1. Agalsidase Beta (Fabrazyme®) IV - Review and revision to guideline consisting of updating the position statement and references.

2. Balloon Ostial Dilation (Balloon Sinuplasty) and Implantable Devices - Review; no change to position statement. Updated description, reimbursement information section and references.

3. Brentuximab (Adcetris™) Injection - Revision to guideline; consisting of updating position statement and references.

4. Cardiac Nuclear Imaging (Myocardial Perfusion Imaging) - Revision; revised position statement. Revised suspected coronary artery disease (CAD): asymptomatic high global risk. Deleted syncope; coronary artery disease (CAD) in the presence of other new cardiac concerns. Updated references.

5. Clotting Factors and Coagulant Blood Products - Review and revision to guidelines; consisting of updating coding and references.

6. Computed Tomographic Angiography (CTA) Heart - Revision; revised position statement. Updated references.

7. Corticosteroid Intravitreal Implant - Review and revision to guideline consisting of updating the description section and references.

8. Eculizumab (Soliris®) Injection - Review and revision to guideline; consisting of updating references.

9. Enteral Formulas - Revision: added coverage statement for enzyme cartridges (E/I). Updated references. Reformatted guideline.

10. Ergotamine (Ergomar) - Review and revision to guideline; consisting of updating references

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

12. Genetic Testing - Revision; position statements, coding, program exception, and references updated.

13. Growth Hormone Therapy - Review and revision to guideline; consisting of updating the position statement and references.

14. Hydroxyprogesterone Caproate - Review and revision to guideline; consisting of updating position statement, coding and references.

15. Investigational Services - Deleted code 0402T; refer to MCG 02-65000-15 Keratoplasty and Keratectomy.

16. Ipilimumab (Yervoy™) Injection - Revision to guideline; consisting of updating position statement, coding and references.

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

18. Keratoplasty and Keratectomy - Revision: added criteria for coverage of corneal collagen cross-linking. Revised description, CPT coding, ICD10 coding, program exception section, and definitions. Updated references.

19. Left Atrial Appendage Closure - Scheduled review. Position statement maintained. Updated references.

20. Lenalidomide (Revlimid®) - Revision of guidelines consisting of adding a new indication of Primary CNS Lymphoma to the position statement based on NCCN Guideline update.

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

22. Magnetic Resonance Imaging (MRI) Cardiac - Revision; removed “chest and” from guideline title, revised position statement and updated references.

23. Meniscal Allograft Transplantation - Revision: added coverage statement regarding use of meniscal implants incorporating materials such as collagen and polyurethane (E/I). Revised program exceptions section, index terms, and HCPCS coding (added code G0428). Updated references. Formatted guideline.

24. Midostaurin (Rydapt) - Revision to guidelines consisting of updating the description section, position statement, and reference based on updated NCCN guidelines for AML.

25. Multiple Gated Acquisition Scan (MUGA) - Revision; revised position statement. Updated references.

26. Multiple Sclerosis Self Injectable Therapy - Revision to guideline; consisting of removal of daclizumab (product no longer available).

27. Nilotinib (Tasigna®) Capsules - Revision to guideline consisting of updates to description, dosage/administration, and references sections based on the new FDA-approved indication for pediatric patients.

28. Nivolumab (Opdivo®) - Revision to guideline; consisting of updating position statement, coding and references.

29. NK-1 receptor antagonist injectable therapy (Emend®, Cinvanti®, Varubi®) - Review and revision to guideline consisting of updating position statement and references.

30. Non-Covered Services - Deleted code G0428 (refer to MCG 02-20000-25, Meniscal Allograft Transplantation).

31. Obeticholic Acid (Ocaliva®) Tablet - Revision to guidelines consisting of updating the position statement.

32. Obinutuzumab (Gazyva™) Injection - Revision to guideline consisting of updating the description section, position statement, and references based on updated NCCN guidelines for CLL/SLL.

33. Oscillatory Devices for the Treatment of Cystic Fibrosis and Other Respiratory Disorders - Revision; description, position statements, program exception, and references updated; formatting changes.

34. Palivizumab (Synagis®) - Review and revision to guideline; consisting of updating description, position statement, other, and references.

35. Pasireotide (Signifor® Signifor LAR®) Injection - Review and revision to guideline; consisting of updating references.

36. PCSK9 Inhibitors - Review and revision to guideline consisting of the description section, position statement, dosage/administration, and references.

37. Pembrolizumab (Keytruda®) Injection - Revision to guideline; consisting of updating position statement, coding and references.

38. Prophylactic Mastectomy - Review; position statements maintained.

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

40. Sodium Oxybate (Xyrem®) Oral - Review and revision to guideline consisting of updating the position statement and references.

41. Tocilizumab (Actemra®) Injection - Revision to guideline consisting of updating the position statement, dosage/administration, and coding/billing.

42. Total Ankle Replacement - Review; description, position statements, coding, and references updated.

43. Tumor Treatment Fields Therapy for Glioblastoma - Scheduled review. Added coverage statement (E/I) for treatment planning software (eg, NovoTAL). Updated references.

44. Tumor/Genetic Markers - Revision; position statements, coding, and references updated.

45. Vascular Endothelial Growth Factor Inhibitors for Ocular Neovascularization - Review and revision to guideline consisting of position statement, coding/billing, and references.



Internet Privacy Statement   |   Terms of Use
 

Date Printed: May 24, 2018: 11:40 AM