Breast Magnetic Resonance Imaging (MRI) |
Re-Reviewed |
10/21/2020
Enhanced benefit
|
Covered for some indications; not covered for screening women at average risk for breast cancer |
Additional covered indication:
A woman who has a lifetime risk of 20% or greater of developing breast cancer as defined by risk assessment models that are largely dependent on family history (e.g., Claus, BRCAPRO, BOADICEA, Tyrer-Cusick).
|
Implantable Deep Brain Stimulation |
Re-Reviewed |
10/21/2020
Enhanced benefit |
Covered for some indications; investigative and therefore not covered for all other indications |
Primary dystonia added to the covered indications. |
Implantable Deep Brain and Responsive Cortical Stimulation
(Formerly titled Implantable Deep Brain Stimulation)
|
New determination for responsive cortical stimulation |
12/21/2020 |
Covered for some indications; investigative and therefore not covered for all other indications |
Responsive cortical stimulation is covered for treatment of localized focal epilepsy when using an FDA-approved device for individuals 18 years or older with all of the following indications:
- A diagnosis of one or two well-identified localized seizure foci
- An average of at least three disabling seizures per month over the prior consecutive three months
- Refractory to two or more antiepileptic medications.
All other indications are investigative and therefore, not covered.
|
Irreversible Electroporation (NanoKnife® System) |
New |
12/21/2020 |
Investigative and therefore not covered |
The NanoKnife System is an ablative device that uses irreversible electroporation (IRE) technology for surgical ablation of soft tissue or of solid organs, such as the liver, pancreas, and kidney.
|
VivAer Nasal Airway Remodeling for Airway Obstruction |
New |
12/21/2020 |
Investigative and therefore not covered
|
The VivAer Nasal Airway Remodeling is proposed for the treatment of nasal valve collapse, and is intended for reshaping nasal tissue to improve air flow. |