Return to Provider News

Medical Policy Update: Minimally Invasive Treatments Prostatic Hyperplasia

Audience: Participating Urologists

Excellus BlueCross BlueShield works to ensure that the development of corporate medical policies occurs through an open, collaborative process. We encourage participating providers to become actively involved in medical policy development. Each month, draft policies are available on our website for review and comment here. Providers now have the capability of attaching supporting documentation related to their comments.

The following updated medical policy has been reviewed and was approved on July 21, 2022, by the Corporate Medical Policy Committee, which includes practitioners from all Health Plan regions.

Corporate Medical Policy 7.01.104 – Minimally Invasive Treatments Prostatic Hyperplasia (BPH) has been updated to be consistent with current literature and American Urological Association recommendations.  This updated policy will be effective November 15, 2022. The policy applies to all lines of business and to the services of all practitioners and facilities.

The BPH policy provides updates to the criteria for the following indication:

  • Treatment of Benign Prostatic Hyperplasia

The rationale section of the medical policy provides information related to the Health Plan’s change in coverage criteria based on The American Urological Association.

These services are subject to audit and policy updates at the Health Plan’s discretion. Access the individual policies here.

If you have any questions regarding this policy, please contact your Provider Relations representative.

Related News
Policy Clarification for Practitioner Medication Dispensing

Streamlined Preauthorization for Medical Specialty Drugs for Commercial Fully Insured Members Effective January 1, 2023

Medicare Advantage Prior Authorization for Select Oncology Medications

Reimbursement for Annual Wellness Visits Effective January 1, 2023

Updated Participating Provider Manual Now Available

Category

Excellus

News

Policies & Clinical Criteria

Utilization Management

IE Browser Modal