Medical Policy Updates

Blue Cross and Blue Shield of North Carolina Medical Policy Update for May 25, 2010

Medical Guidelines	Reason for Update
Evidence Based Guidelines
Apnea Monitor for Use in the Home	Description section revised. Evidence Based Guideline revised to read: "Home cardiorespiratory monitoring (pneumogram)may be considered appropriate for use in infants younger than 12 months of age in the following situations: Those who have experienced an apparent life-threatening event; OR Those with tracheostomies or anatomic abnormalities that make them vulnerable to airway compromise; OR Those with neurologic or metabolic disorders affecting respiratory control, including central sleep apnea; OR Those with chronic lung disease (i.e., bronchopulmonary dysplasia), particularly those requiring supplemental oxygen; continuous positive airway pressure; or mechanical ventilation." Also added the following statement: "Note: Home cardiorespiratory monitoring is intended, in part, to alert caregivers of the need for intervention at the time of an event in patients with apnea, and is not appropriate for diagnosis of sleep-disordered breathing (central or obstructive)." Information in the When It Is Not Recommended section updated. References updated.
Drug Eluting Coronary Stent	Policy status changed to "Active policy, no longer scheduled for routine literature review". Reformatted the section titled, "Medical Evidence regarding Drug Eluting Coronary Stent indicates it is not recommended in the following situations". References updated. Removed the Guideline Policy number.
Ultrasound Screening for Abdominal	Senior Medical Director review. Status changed to Active Archive. No longer scheduled for routine literature review.