Insurance Updates: August 25

By Policy and Advocacy Brief posted 08-25-2021 10:25

  

Insurance Updates:  August 25, 2021

Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes the release of policies regarding prostate biopsies and erectile dysfunction.

BCBS New Mexico

BCBS New Mexico revised its Prostate Biopsies (Commercial) Policy adding the following statements:

  • Medical necessity:
    • Comprehensive 3D (three-dimensional) mapping with biopsy involving 12 core extended sampling in the initial diagnosis of prostate cancer as a follow up to abnormal PSA results, presence of a palpable nodule on digital rectal examination, or suspicious radiologic findings
  • Non-covered:
    • Comprehensive 3D mapping with biopsy are not covered and therefore will not be reimbursed for the diagnosis, staging and management of prostate cancer

Read the update.

BCBS Texas

BCBS Texas reviewed its Erectile Dysfunction (Commercial) Policy stating erectile dysfunction testing may be considered medically necessary when criteria are met.

Read the update.

BCBS Texas reviewed its Prostate Biopsies (Commercial) Policy stating prostate biopsies may be considered medically necessary when criteria are met.

Read the update.

BCBS Texas reviewed its Urinary Tumor Markers for Bladder Cancer (Commercial) Policy stating urinary tumor markers for bladder cancer may be considered medically necessary when criteria are met.

Read the update.

0 comments
4 views

Permalink