Recent Updates

Effective 12/27/2017  
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
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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Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.