The NCDs below are organized into separate tables by NCD Section. NCDs within each table are organized by NCD ID.
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1 Three Penn Plaza East Newark, NJ HorizonBlue.com NCDs and LCDs to Be Implemented Claims submitted for services provided on and after April 9, 2018 to Horizon BCBSNJ MA members will be processed following the guidelines set forth in the NCDs, LCDs and/or their supporting articles listed below. The LCDs below are organized by LCD ID. LCD Title Assays for Vitamins and Metabolic Function Surgery: Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control Allergy Testing Intensity Modulated Radiation Therapy (IMRT) BRCA1 and BRCA2 Genetic Testing Reflectance Confocal Microscopy Electroretinography (ERG) LCD ID L34914 L35011 L36241 L36711 L36715 L37375 L37371 The NCDs below are organized into separate tables by NCD Section. NCDs within each table are organized by. NCD Section 10: Anesthesia and Pain Management Autogenous Epidural Blood Graft 10.5 Anesthesia in Cardiac Pacemaker Surgery 10.6 NCD Section 20: Cardiovascular System Vertebral Artery Surgery 20.1 Cardiac Rehabilitation Programs for Chronic Heart Failure Intraoperative Ventricular Mapping Diagnostic Endocardial Electrical Stimulation Pacing HIS Bundle Study Cardiac Output Monitoring by Thoracic Electrical Bio-impedance (TEB) Ambulatory Blood Pressure Monitoring External Counterpulsation ECP Therapy for Severe Angina 20.2 Extracranial-Intracranial (EC-IC) Arterial Bypass Surgery 20.2 Chelation Therapy for Treatment of Atherosclerosis EthylenediamineTetraAcetic (EDTA) Chelation Therapy for Treatment of Atherosclerosis Fabric Wrapping of Abdominal Aneurysms Partial Ventriculectomy Cardiointegram CIG as an Alternative to Stress Test or Thallium Stress Test Hyperbaric Oxygen Therapy CMC An Independent Licensee of the Blue Cross and Blue Shield Association.
2 NCD Section 20: Cardiovascular System (continued) Microvolt TWave Alternans (MTWA) 20.3 Intensive Cardiac Rehabilitation (ICR) Programs Transcatheter Aortic Valve Replacement (TAVR) The Pritikin Program Ornish Program for Reversing Heart Disease Intensive Cardiac Rehabilitation Program Benson-Henry Institute Cardiac Wellness Program Transcatheter Mitral Valve Repair (TMVR) Percutaneous Left Atrial Appendage Closure (LAAC) Extracorporeal Immunoadsorption (ECI) Using Protein A Columns 20.5 Transmyocardial Revascularization (TMR) 20.6 Percutaneous Transluminal Angioplasty (PTA) 20.7 Artificial Hearts and Related Devices 20.9 NCD section 30: Complementary and Alternative Medicine Laetrile and Related Substances 30.7 Cellular Therapy 30.8 NCD section 40: Endocrine System and Metabolism Outpatient Intravenous Insulin Treatment 40.7 NCD section 70: Evaluation & Management of Patients - office/hospital/home Consultation Services Rendered by a Podiatrist in a Skilled Nursing Facility 70.2 NCD Section 80: Eye PhacoEmulsification Procedure Cataract Extraction 80.1 Vitrectomy Hydrophilic Contact Lenses 80.4 Intraocular Photography 80.6 Refractive Keratoplasty 80.7 NCD section 90: Genetics Pharmacogenomic Testing for Warfarin Response 90.1 NCD section 100: Gastrointestinal System Surgery for Diabetes Hour Ambulatory Esophageal ph Monitoring Gastric Freezing 100.6
3 NCD Section 110: Hematology/Immunology/Oncology Challenge Ingestion Food Testing Apheresis Therapeutic Pheresis Stem Cell Transplantation Formerly Extracorporeal Photopheresis NCD Section 130: Mental Health Hemodialysis for Treatment of Schizophrenia NCD section 140: Miscellaneous Surgical Procedures Abortion Plastic Surgery to Correct Moon Face NCD section 150: Musculoskeletal System Lumbar Artificial Disc Replacement LADR Manipulation Thermal Intradiscal Procedures (TIPs) Collagen Meniscus Implant Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee NCD section 160: Nervous System Induced Lesions of Nerve Tracts Invasive Intracranial Pressure Monitoring Electrotherapy for Treatment of Facial Nerve Paralysis Bell s Palsy Sensory Nerve Conduction Threshold Tests (sncts) Deep Brain Stimulation for Essential Tremor and Parkinson s Disease Stereotaxic Depth Electrode Implantation Electrical Nerve Stimulators NCD Section 190: Pathology and Laboratory Histocompatibility Testing Diagnostic Pap Smears Sweat Test Hair Analysis Lymphocyte Mitogen Response Assays NCD section 210: Pathology and Laboratory Prostate Cancer Screening Tests Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) to Prevent STIs Intensive Behavioral Therapy for Cardiovascular Disease Intensive Behavioral Therapy for Obesity
4 NCD section 210: Pathology and Laboratory (continued) Screening for Hepatitis C Virus (HCV) in Adults Lung Cancer Screening with Low Dose Computed Tomography (LDCT) Screening Pap Smears and Pelvic Examinations for Early Detection of Cervical or Vaginal Cancer Screening for Cervical Cancer With Human Papillomavirus (HPV) Testing Counseling to Prevent Tobacco Use Screening for Hepatitis B Virus (HBV) Infection Screening for the Human Immunodeficiency Virus HIV Infection Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse Screening for Depression in Adults NCD section 220: Radiology Thermography Percutaneous Image Guided Breast Biopsy NCD section 230: Renal and Genitourinary System - ERSD Services Treatment of Kidney Stones Dimethyl Sulfoxide (DMSO) Ultrafiltration Monitor Sacral Nerve Stimulation For Urinary Incontinence Uroflowmetric Evaluations Sterilization Cryosurgery of Prostate NCD section 240: Respiratory System Lung Volume Reduction Surgery Reduction Pneumoplasty Heat Treatment including the use of Diathermy and Ultrasound for Pulmonary Conditions Sleep Testing for Obstructive Sleep Apnea (OSA) NCD section 250: Skin Treatment of Psoriasis Dermal Injections for the Treatment of Facial Lipodystrophy Syndrome (LDS) NCD section 260: Transplantation - Solid Organ Transplants Adult Liver Transplantation Heartsbreath Test for Heart Transplant Rejection Pediatric Liver Transplantation Pancreas Transplants Islet Cell Transplantation in the Context of a Clinical Trial Intestinal and MultiVisceral Transplantation Dental Examination Prior to Kidney Transplantation 260.6
5 NCD section 260: Transplantation - Solid Organ Transplants (continued) Lymphocyte Immune Globulin AntiThymocyte Globulin Equine Heart Transplants NCD section 270: Wound Treatment Electrical Stimulation ES and Electromagnetic Therapy for the Treatment of Wounds Blood Derived Products for Chronic Non-Healing Wounds NCD section 300: Diagnostic Tests Not Otherwise Classified Obsolete or Unreliable diagnostic tests 300.1
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