Insurance Updates:  March 3, 2021

By Policy and Advocacy Brief posted 03-03-2021 11:35


Insurance Updates:  March 3, 2021

Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes the release of COVID-19 and telehealth/telemedicine specific newsletters and policy updates. Blue Cross Blue Shield (BCBS) Kansas reviewed its Prostatic Urethral Lift Policy.

Additionally, BCBS North Carolina updated its Botulinum Toxin Policy.

COVID-19 Updates:

BCBS Western New York (NY)

BCBS Western NY published its Provider Information Regarding COVID 19 (Coronavirus) News & Announcements bulletin announcing:

  • Continued waiver of the cost-share for COVID-19 diagnostic testing for Commercial, Medicare Advantage and ASO members
  • More information about COVID-19 vaccines, including addressing common vaccine myths, BlueCross BlueShield patients can visit BCBS Western NY’s Member FAQ page

Read the update.

CGS Administrators

CGS Administrators released its J15 Medicare Bulletin News & Announcements, which includes Part A/HH&H Billing Guidance for COVID-19 Vaccine and Monoclonal Antibody Infusion.

Read the update.


National Insurance Carriers/MACs Updates:


Aetna reviewed its Benign Prostatic Hyperplasia Medical Policy clarifying that Rezum system is also known as convective radiofrequency transurethral water vapor therapy, and removing HCPCS code C9747.

Read the update.

BCBS Kansas

BCBS Kansas reviewed its Prostatic Urethral Lift Medical Policy removing “contact dermatitis” from criterion stating member does not have a nickel allergy.

Read the update.

BCBS North Carolina

BCBS North Carolina reviewed its Botulinum Toxin Medical Policy with the following changes:

  • Added neurogenic detrusor overactivity in patients 5 years of age and older as an FDA-approved indication and the following covered criterion:
    • Neurogenic detrusor overactivity (NDO)* in pediatric patients 5 years of age or older who have an inadequate response to or are intolerant of an anticholinergic medication.

Read the update.

United Healthcare

United Healthcare reviewed its Prostate Surgery (Commercial) Medical Policy adding documentation requirements section, including requirements for the following procedures:

  • Transurethral ablation
  • Cryoablation of the prostate
  • Surgical – radical prostatectomy
  • Prostatic urethral lift

Read the update.