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Final Policies: A - E

Policy # Policy Title View
BA-626 Ablative Procedures of Peripheral Nerves for Treatment of Musculoskeletal Conditions
BA-721 Absorbable Nasal Implant for Treatment of Nasal Valve Collapse
BA-179 Acoustic Cardiography
BA-476 Adipose-derived Stem Cells in Autologous Fat Grafting to the Breast
BA-743 Adjunctive Techniques for Screening and Surveillance of Barrett Esophagus and Esophageal Dysplasia
BA-105 Adoptive Immunotherapy
BA-081 Allergy Immunotherapy
BA-071 Allergy Testing
BA-741 Allograft Injection for Degenerative Disc Disease
BA-624 Amniotic Membrane Transplantation for the Ocular Surface
BA-176 Analysis of Proteomic Patterns in Serum to Identify Cancer
BA-311 Anterior Eye Segment Optical Imaging
BA-353 Anti-CCP Testing for Rheumatoid Arthritis
BA-165 Antigen Leukocyte Antibody Test
BA-280 Antineoplaston Cancer Therapy
BA-096 Antiprothrombin Antibody
BA-324 Aqueous Shunts and Stents for Glaucoma
BA-146 Auditory Brain Stem Implant
BA-156 Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions
BA-137 Automated Percutaneous and Percutaneous Endoscopic Discectomy
BA-573 Autonomic Nervous System Testing
BA-182 Axial Lumbar Interbody Fusion
BA-704 Balloon Dilation of the Eustachian Tube
BA-480 Baroreflex Stimulation Devices
BA-055 Bi-Ventricular Pacemakers (Cardiac Resynchronization Therapy) for the Treatment of Heart Failure
BA-438 Bioimpedance Devices for Detection of Lymphedema
BA-232 Biophysical Fetal Profile
BA-262 Bispectral Index Monitoring During General Anesthesia
BA-189 Bone Morphogenetic Protein
BA-266 Boniva® (Ibandronate Sodium) Infusion
BA-434 Bronchial Thermoplasty
BA-441 Cardiac Hemodynamic Monitoring for the Management of Heart Failure in the Outpatient Setting
BA-198 Cardiopulmonary Exercise Stress Test (CPET-CPX)
BA-432 Cellular Immunotherapy for Prostate Cancer
BA-085 Chelation Therapy
BA-052 Chemical Peels
BA-494 Chromoendoscopy as an Adjunct to Colonoscopy
BA-521 Composite Tissue Allotransplantation (CTA) of the Hand and Face - Blue Advantage
BA-204 Computed Tomography Perfusion Imaging of the Brain
BA-229 Computer-Assisted Navigation for Orthopedic Procedure
BA-020 Computerized Pulse Waveform Analysis
BA-520 Confocal Laser Endomicroscopy
BA-188 Constraint-Induced Movement or Language Therapy
BA-038 Continuous Glucose Monitoring
BA-639 Corneal Collagen Cross-Linking
BA-021 Cranial Electrotherapy Stimulation (CES) and Auricular Electrostimulation
BA-429 Cryoablation of Tumors (Excluding Liver or Prostate Tumors)
BA-744 Cryoablation, Radiofrequency Ablation and Laser Ablation for Treatment of Chronic Rhinitis
BA-090 Decompression of the Intervertebral Disc Using Laser Energy (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty)
BA-216 Dermal Fillers and Bulking Agents for Vocal Cord Insufficiency
BA-267 Diagnosis and Management of Idiopathic Environmental Intolerance (i.e., Multiple Chemical Sensitivities)
BA-477 Diagnosis and Treatment of Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis
BA-558 Diagnosis and Treatment of Sacroiliac Joint Pain
BA-252 Digital Breast Tomosynthesis
BA-368 Digital Electroencephalography (DEEG) Analysis
BA-750 Digital Health Technologies (Diagnostic Applications)
BA-755 Digital Health Technologies- Therapeutic Applications
BA-742 Digital Health Therapies for Attention Deficit or Hyperactivity Disorder
BA-736 Digital Health Therapies for Substance Use
BA-292 Disposable Arthroscopy
BA-504 Dopamine Transporter Imaging with Single Photon Emission Computed Tomography (DAT-SPECT)
BA-749 Dry Hydrotherapy for Chronic Pain Conditions
BA-735 DURYSTA (bimatoprost implant)
BA-511 Dynamic Spinal Visualization and Vertebral Motion Analysis
BA-309 Electrocardiographic Body Surface Mapping
BA-196 End-Tidal Carbon Monoxide Measurement (ETCOc)
BA-576 Endobronchial Ultrasound for Diagnosis and Staging of Lung Cancer
BA-453 Endometrial Ablation
BA-645 Endovascular Stent Grafts for Abdominal Aortic Aneurysms
BA-637 Endovascular Stent Grafts for Thoracic Aortic Aneurysms or Dissections
BA-579 Endovascular Therapies for Extracranial Vertebral Artery Disease
BA-200 Evaluation of Biomarkers for Alzheimer Disease
BA-224 Extracorporeal Shock Wave Lithotripsy (ESWL) for Pancreatic Stones
BA-076 Extracorporeal Shock Wave Treatment for Plantar Fasciitis and Other Musculoskeletal Conditions
BA-522 Eyelid Thermal Pulsation for the Treatment of Dry Eye Syndrome