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Medical Policy Update for August 23, 2022
| Medical Guidelines | Reason for Update |
|---|---|
| Capsule Endoscopy, Wireless (PDF) | Typo corrected under When Not Covered section. No change to policy statement. |
| Diagnosis of Vaginitis including Multi-target PCR Testing AHS – M2057 (PDF) | Added the following statement to When Not Covered section “Reimbursement is not allowed for screening of bacterial vaginosis using Aptima BV.” Medical Director review 8/2022. |
| Facet Joint Denervation (PDF) | Criteria moved from Policy Guidelines section to When Covered section for clarity. No change to policy statement. Medical Director review 8/2022. |
| Quantose Impaired Glucose Tolerance (IGT) Test AHS - G2135 | Test no longer available. Medical director review. Policy archived. |
| Therapeutic Radiopharmaceuticals in Oncology (PDF) | Policy statement updated to include coverage of Lutetium 177 (Lu 177) vipivotide tetraxetan (Pluvicto). No change to policy intent. Medical Director review 8/2022. |
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