Recent Updates

PW_A092170
Effective 12/27/2017  
 
New 
CG-DME-40 Electrical Bone Growth Stimulation
CG-DME-41 Ultraviolet Light Therapy Delivery Devices for Home Use
CG-DRUG-65 Tumor Necrosis Factor Antagonists
CG-DRUG-66 Panitumumab (Vectibix®)
CG-DRUG-68 Bevacizumab (Avastin®) for Non-Ophthalmologic Indications
CG-DRUG-69 Ustekinumab (Stelara®)
CG-DRUG-70 Eribulin mesylate (Halaven®)
CG-DRUG-71 Ziv-aflibercept (Zaltrap®)
CG-DRUG-72 Pertuzumab (Perjeta®)
CG-DRUG-73 Denosumab (Prolia®, Xgeva®)
CG-DRUG-74 Canakinumab (Ilaris®)
CG-DRUG-75 Romiplostim (Nplate®)
CG-DRUG-76 Plerixafor Injection (Mozobil™)
CG-DRUG-77 Radium Ra 223 Dichloride (Xofigo®)
CG-DRUG-78 Antihemophilic Factors and Clotting Factors
CG-DRUG-79 Siltuximab (Sylvant®)
CG-DRUG-80 Cabazitaxel (Jevtana®)
CG-DRUG-81 Tocilizumab (Actemra®)
CG-GENE-01 Janus Kinase 2 (JAK2) V617F Gene Mutation Assay
CG-GENE-02 Analysis of KRAS Status
CG-GENE-03 BRAF Mutation Analysis
CG-GENE-04 Molecular Marker Evaluation of Thyroid Nodules
CG-MED-60 Anesthesia During Cataract Surgery
CG-MED-61 Preoperative Testing for Low Risk Invasive Procedures and Surgeries
CG-MED-62 Resting Electrocardiogram Screening in Adults
CG-MED-63 Treatment of Hyperhidrosis
CG-MED-64 Transcatheter Ablation of Arrhythmogenic Foci in the Pulmonary Veins as a Treatment of Atrial Fibrillation or Atrial Flutter (Radiofrequency and Cryoablation)
CG-MED-65 Manipulation Under Anesthesia of the Spine and Joints other than the Knee
CG-MED-66 Cryopreservation of Oocytes or Ovarian Tissue
CG-MED-67 Melanoma Vaccines
CG-MED-68 Therapeutic Apheresis
CG-SURG-61 Cryosurgical Ablation of Solid Tumors Outside the Liver
CG-SURG-62 Radiofrequency Ablation to Treat Tumors Outside the Liver
CG-SURG-63 Cardiac Resynchronization Therapy (CRT) with or without an Implantable Cardioverter Defibrillator (CRT/ICD) for the Treatment of Heart Failure
CG-SURG-65 Recombinant Human Bone Morphogenetic Protein
CG-SURG-66 Implanted (Epidural and Subcutaneous) Spinal Cord Stimulators (SCS)
CG-SURG-67 Treatment of Osteochondral Defects
CG-SURG-68 Surgical Treatment of Femoracetabular Impingement Syndrome
CG-SURG-69 Meniscal Allograft Transplantation of the Knee
 
Revised  
CG-ADMIN-02 Clinically Equivalent Cost Effective Services – Targeted Immune Modulators
CG-ANC-04 Ambulance Services: Air and Water
CG-ANC-05 Ambulance Services: Ground; Emergent
CG-DME-31 Wheeled Mobility Devices: Wheelchairs–Powered, Motorized, With or Without Power Seating Systems and Power Operated Vehicles (POVs)
CG-DRUG-05 Recombinant Erythropoietin Products
CG-DRUG-19 Progesterone Therapy as a Technique to Prevent Preterm Delivery in High-Risk Women
CG-DRUG-38 Pemetrexed Disodium (Alimta®)
CG-DRUG-45 Octreotide acetate (Sandostatin®; Sandostatin® LAR Depot)
CG-DRUG-50 Paclitaxel, protein-bound (Abraxane®)
CG-DRUG-61 Gonadotropin Releasing Hormone Analogs for the Treatment of Non-Oncologic Indications
CG-LAB-10 Zika Virus Testing
CG-MED-21 Anesthesia Services and Moderate (“Conscious”) Sedation
CG-MED-24 Electromyography and Nerve Conduction Studies
CG-MED-39 Central (Hip or Spine) Bone Density Measurement and Screening for Vertebral Fractures Using Dual Energy X-Ray Absorptiometry
CG-MED-46 Ambulatory Electroencephalography and Video Electroencephalography
CG-SURG-31 Treatment of Keloids and Scar Revision
CG-SURG-59 Vena Cava Filters
 
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