Providers

Medical Policy Upcoming Updates

Notification Date: March 16, 2022

Below are the policies that are new or have been reviewed, along with the determination and summary of any changes.

Policy Title	Status	Effective Date	Determination	Summary of Change
Continuous Glucose Monitoring (CGM)	Re-Review	03/16/2022 Enhanced Benefit	Covered for some indications; investigative and therefore not covered for all other indications	The following indications are now considered covered services: Short Term CGM: Management of recurrent hypoglycemia. Long Term CGM: Management of recurrent hypoglycemia Implantable real-time CGM (e.g., Eversense). All other indications remain as previously determined. See the coverage policy for additional information.
Genetic Testing for Thyroid Cancer	Re-Reviewed	03/16/2022 Enhanced Benefit	Covered for some indications; investigative and therefore not covered for all other indications	The following indications are now considered covered services: Thyroid gene expression profiling of thyroid nodules in fine-needle aspirate (FNA) specimens, to assess for thyroid cancer for Bethesda System class III or IV categories for reporting indeterminate thyroid cytopathology. The Afirma® Gene Expression Classifier (GSC) for assessing indeterminate thyroid nodules, class III or IV categories of the Bethesda system for reporting cytopathology. All other indications remain as previously determined. See the coverage policy for additional information.

Policy Title

Status

Effective Date

Determination

Summary of Change

Continuous Glucose Monitoring (CGM)

Re-Review

03/16/2022
Enhanced Benefit

Covered for some indications; investigative and therefore not covered for all other indications

The following indications are now considered covered services:

Short Term CGM:

Long Term CGM:

All other indications remain as previously determined. See the coverage policy for additional information.

Genetic Testing for Thyroid Cancer

Re-Reviewed

03/16/2022
Enhanced Benefit

Covered for some indications; investigative and therefore not covered for all other indications

The following indications are now considered covered services:

Thyroid gene expression profiling of thyroid nodules in fine-needle aspirate (FNA) specimens, to assess for thyroid cancer for Bethesda System class III or IV categories for reporting indeterminate thyroid cytopathology.
The Afirma® Gene Expression Classifier (GSC) for assessing indeterminate thyroid nodules, class III or IV categories of the Bethesda system for reporting cytopathology.

All other indications remain as previously determined. See the coverage policy for additional information.