Medical Policy Updates

Notification of Policy Revisions Effective October 28, 2004 (Posted August 26, 2004)

Medical Policy	Revision
Analysis of Proteomic Patterns in Serum to Identify Ovarian Cancer	New policy written. Analysis of proteomic patterns in serum to identify ovarian cancer is considered investigational. Notification given 8/26/04. Effective date 10/28/04.
Evoked Otoacoustic Emissions	Specialty Matched Consultant Advisory Panel review. Under "When Covered" section, added bullet: "For monitoring cochlear damage when ototoxic drugs are administered (i.e., during chemotherapy with ototoxic agents)." Notification given 8/26/04. Effective 10/28/04.
Partial Left Ventriculectomy	CPT code 33416 deleted. CPT code 33542 added as consistent with BCBSA policy. No change to policy criteria. Code 33542 to be denied as investigational if determined, by operative report, to be a partial left ventriculectomy. Notification 8/26/2004. Effective 10/28/2004.