Medical Policies
Home
Category Filter
policies & guidelines
Blue Advantage Policies
Provider-Administered Drug Policies
Current Provider-Administered Drug Policies
Draft Provider-Administered Drug Policies
HelpScript Program
Hemophilia Drugs
Draft Hemophilia Drug Policies
Final Hemophilia Drug Policies
Hemophilia Drug Prior Authorization
PEEHIP Hemophilia Drug Program
Provider-Administered Drug Policies
Draft Provider-Administered Drug Policies
Drug Wastage Program
Final Provider-Administered Drug Precertification Policies
Mandatory Site of Service
Provider-Administered Drug Claim Edit Policies
Voluntary Site of Service
Self-Administered Drug Policies
Final Self-Administered Drug Policies
Self-Administered Drug Prior Authorization Forms
Asset Publisher
< Back to Blue Advantage
®
Final Medical Policies page
Final Policies: O - S
Policy #
Policy Title
View
BA-022
Occlusion of Uterine Arteries Using Transcatheter Embolization or Laparoscopic Occlusion to Treat Uterine Fibroids
BA-337
Oncologic Applications of Photodynamic Therapy, Including Barrett’s Esophagus
BA-631
Open and Thoracoscopic Approaches to Treat Atrial Fibrillation and Atrial Flutter (Maze and Related Procedures)
BA-465
Ophthalmologic Techniques That Evaluate the Posterior Segment for Glaucoma
BA-248
Osteochondral Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions
BA-454
Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux
BA-301
Phototherapy for the Treatment of Skin Disorders
BA-119
Radiofrequency Ablation of Solid Tumors Excluding Liver Tumors
BA-574
Responsive Neurostimulation for the Treatment of Refractory Focal Epilepsy
BA-174
Risk-Reducing Mastectomy
BA-452
Scintimammography and Gamma Imaging of the Breast and Axilla
BA-161
Serologic Diagnosis of Celiac Disease
BA-346
Stretching and Splinting Devices for the Treatment of Joint Stiffness and Contractures
BA-312
Suprachoroidal Delivery of Pharmacological Agents
BA-421
Surgical Treatment of Femoroacetabular Impingement
BA-735
Sustained-Release Intracameral Glaucoma Therapy Policy
Hidden