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Medical & Pharmacy Policy Update

Blue Cross and Blue Shield of Kansas (BCBSKS) has published the following updated medical policies on the BCBSKS Website. Click on a link to view the details of each policy.

Published 07/01/22:

  • Artificial Intervertebral Disc: Cervical Spine
  • Artificial Intervertebral Disc: Lumbar Spine  
  • Ambulatory Event Monitors and Mobile Cardiac Outpatient Telemetry     
  • Wearable Cardioverter Defibrillators 
  • Catheter Ablation as Treatment for Atrial Fibrillation
  • Implanted Peripheral Nerve Stimulator (PNS) for Pain Control
  • Immunoglobulin Therapy

Pharmacy Policies:

  • IL-13 antagonist
  • Insulin Pump
  • Factor VIII and VW Factor
  • Lupus  

Many of our pharmacy medical policies are maintained through our pharmacy benefit manager, Prime Therapeutics.

To find pharmacy medical policies specific to a medication list, please select a medication list at the bottom of our prior authorization page of our website, https://www.bcbsks.com/providers/precertification-prior-authorization

The following Medical Policies had new codes effective 07/01/22:

  • Bio-Engineered Skin and Soft Tissue Substitutes
  • Cochlear Implant
  • Corneal Collagen Cross-Linking
  • Continuous Glucose Monitoring
  • Interspinous and Interlaminar Stabilization / Distraction Devices (Spacers)
  • Optical Coherence Tomography (OCT) of the Anterior Eye Segment
  • Orthopedic Applications of Stem Cell Therapy (Including Allograft and Bone Substitute Products Used With Autologous Bone Marrow)
  • Positron Emission Tomography (PET) Scanning: Oncologic Applications

If you have questions regarding this publication, please contact your BCBSKS provider consultant/representative.

Institutional Providers
Professional Providers