Allogeneic Pancreatic Islet Cell Transplantation
|
Re-Reviewed
|
12/17/2018 |
Investigative and therefore not covered
|
No change in determination
|
Genetic and Pharmacogenetic Testing |
Re-Reviewed |
12/17/2018 |
Covered for some indications |
No change in determination |
Laboratory Tests |
Re-Reviewed |
12/17/2018 |
Covered for some indications; investigative and therefore not covered for all other indications |
No change in determination |
Minimally Invasive Spine Surgeries |
Re-Reviewed |
12/17/2018 |
Covered for some indications; investigative and therefore not covered for all other indications |
No change in determination |
Prostate Health Index (PHI) Lab Test |
New |
12/17/2018 |
Covered for some indications; investigative and therefore not covered for all other indications |
Not Investigative Determination:
- Screening and detection of prostate cancer, in men age 50 years and older, with prostate-specific antigen (PSA) results in the range of 4 to 10 ng/mL, and who have a negative digital rectal examination (FDA approved indications).
Investigative Determination:
- Screening and detection of prostate cancer for all other indications.
|
Stem Cell Therapy for Orthopedic Applications |
Re-Reviewed |
12/17/2018 |
Investigative and therefore not covered |
No change in determination
Further defined that this investigative indication includes:
- Concentrated, engineered or expanded stem cells
- Allograft bone products containing stem cells.
|
Transmyocardial Revascularization |
Re-Reviewed |
12/17/2018 |
Covered for some indications; investigative and therefore not covered for all other indications |
No change in determination |