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Draft Medical Policies

Draft medical policies are listed below. If there are no policies listed, it means there are currently no policies in draft status.

Note: Coverage is subject to the member's specific benefits. Group-specific benefits will supersede these policies when applicable. Always check eligibility and benefits through your local Blue Plan provider portal or your practice management system to confirm member-specific benefits. 

Comment on Draft Medical Policies

Participating providers are invited to submit scientific, evidence-based information, professional consensus opinions and other information supported by medical literature relevant to these draft policies for consideration.

We accept comments for 45 days from the posting date listed on the draft policy.

Make sure your voice is heard by providing feedback directly to us:

Birmingham Service Center
Attn: Health Management - Medical Policy
P.O. Box 10527
Birmingham, AL 35202

Fax: 205-220-0878

Draft Policies

Policy # Policy Title Print View
MP-083 Microprocessor-Controlled Prostheses for the Lower Limb
MP-124 Myoelectric Prosthetic and Orthotic Components for the Upper Limb
MP-200 Evaluation of Biomarkers for Alzheimer Disease
MP-202 Vertebral Fracture Assessment with Dual X-Ray Absorptiometry (DEXA) or Biomechanical Computed Tomography
MP-575 Powered Exoskeleton
MP-682 Water Vapor Energy Ablation and Waterjet Tissue Ablation for Benign Prostatic Hyperplasia
MP-724 Hydrogel Spacer use During Radiotherapy for Prostate Cancer
MP-743 Adjunctive Techniques for Screening, Surveillance, and Risk Classification of Barrett Esophagus and Esophageal Dysplasia