Blue Cross Blue Shield - Louisiana Coverage Criteria
- Blue Cross Blue Shield - Louisiana prior authorization
- All Blue Cross Blue Shield - Louisiana policy updates
Latest Blue Cross Blue Shield - Louisiana coverage criteria updates25
- Coverage CriteriaClinical/Medical PolicyEff. 2026-10-01Extracranial Carotid Angioplasty/StentingDefines coverage criteria, limitations, and supporting rationale for carotid artery angioplasty with stenting and transcarotid artery revascularization for extracranial carotid stenosis for members of Blue Cross and Blue Shield of Louisiana.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-09-15Allergen TestingDefines coverage criteria and limitations for in‑vitro and skin‑based allergen testing, including specific IgE, total IgE, basophil activation testing, proprietary panels, and other ancillary tests for Blue Cross Blue Shield of Louisiana members.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-09-15Cardiovascular Disease Risk AssessmentDefines coverage criteria for tests and panels used to assess cardiovascular disease risk (lipid panels, biomarkers, and related assays) and specifies which tests meet or do not meet Blue Cross and Blue Shield of Louisiana coverage for providers requesting CVD risk assessment testing.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-09-15Diagnostic Testing of Common Sexually Transmitted InfectionsCoverage policy for laboratory testing of common STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Trichomonas vaginalis, HSV, HPV, and select others) describing when tests meet or do not meet coverage criteria for Blue Cross and Blue Shield of Louisiana members.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-09-15Human Immunodeficiency Virus (HIV)Defines coverage, limitations, and clinical background for HIV screening, confirmatory testing, nucleic acid testing, viral load monitoring, and genotypic/phenotypic resistance assays for affected individuals and providers.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-09-15Lyme Disease TestingDefines coverage criteria for laboratory testing to diagnose Lyme disease, specifying when serologic, molecular, and other tests meet or do not meet coverage for Blue Cross Blue Shield of Louisiana members.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-09-15Prostate Specific Antigen (PSA) TestingCoverage and clinical guidance for use of total PSA and select PSA-related tests for screening, diagnosis, monitoring, and treatment management of prostate cancer for individuals with a prostate; includes age- and risk-based screening intervals and tests that do not meet coverage criteria.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-09-15Thyroid Disease TestingCriteria for coverage of laboratory testing for thyroid function, antibodies, and related serum markers; governs when Blue Cross and Blue Shield of Louisiana will cover specific thyroid tests for members and how frequently they may be performed.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-09-15Venous and Arterial Thrombosis Risk TestingPolicy governing coverage and limitations for laboratory testing to evaluate inherited and acquired thrombophilias and related assays for venous and arterial thrombosis risk; applies to Blue Cross and Blue Shield of Louisiana members and providers requesting such testing.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-09-01Bronchial ValvesPolicy governing coverage of bronchial (endobronchial/intrabronchial) valves for treatment of prolonged air leaks and for bronchoscopic lung volume reduction in adults with severe emphysema; applies to products administered or underwritten by the Health Plan.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-09-01Secukinumab (Cosentyx) — intravenous (Medicare Advantage)Medicare Advantage medical policy governing coverage criteria for intravenous secukinumab (Cosentyx) for adults with psoriatic arthritis, ankylosing spondylitis, and non-radiographic axial spondyloarthritis for members of the Health Plan.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-08-01Evaluation of Dry EyesDefines coverage policy for diagnostic tests used to evaluate dry eye disease (DED), specifying which tear film biomarker tests meet or do not meet coverage criteria and intended for clinicians and laboratories submitting claims to Blue Cross Blue Shield of Louisiana.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-08-01Helicobacter pylori TestingCoverage criteria for diagnostic and post-treatment testing for Helicobacter pylori infection, including which test types are covered or not and age- or indication-specific limitations, for Blue Cross Blue Shield of Louisiana members.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-08-01Hepatitis TestingClinical coverage policy describing when laboratory testing for hepatitis A, B, C, and D meets coverage criteria for Blue Cross Blue Shield of Louisiana members; applies to provider requests for diagnostic and screening tests.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-08-01Intravitreal and Suprachoroidal Corticosteroid ProductsThis policy governs coverage and medical necessity criteria for intravitreal and suprachoroidal corticosteroid implants and injections (e.g., Retisert, Iluvien, Yutiq, Ozurdex, Xipere) for ocular conditions such as non-infectious uveitis, macular edema after retinal vein occlusion, and diabetic macular edema for members of Blue Cross and Blue Shield of Louisiana and HMO Louisiana, Inc.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-08-01Laser Interstitial Thermal Therapy for Neurological ConditionsThis policy describes coverage and investigational determinations for MR-guided laser interstitial thermal therapy (LITT/MRgLITT) for neurological conditions, specifying criteria for coverage in drug-resistant disabling epilepsy and deeming other indications investigational; it applies to all products under the Health Plan unless contract exceptions apply.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-08-01Prescription Medication and Illicit Drug Testing in the Outpatient SettingCoverage criteria for presumptive and definitive outpatient drug testing (primarily urine/oral fluid) for prescription and illicit substances; applies to outpatient clinical toxicology (not forensic or therapeutic drug monitoring) for Blue Cross Blue Shield - Louisiana members.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-08-01Salivary Hormone TestingDefines coverage stance for salivary hormone tests (including late-night salivary cortisol and other salivary steroid panels) for Blue Cross Blue Shield of Louisiana members, specifying indications that meet or do not meet coverage criteria.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-08-01Urinary Tumor Markers for Bladder CancerThis policy governs coverage criteria for urinary tumor marker tests used to detect or monitor bladder cancer for members of Blue Cross Blue Shield - Louisiana. It specifies when certain urinary biomarker tests meet coverage criteria and which tests do not meet coverage criteria.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-07-01Total Artificial Hearts and Implantable Ventricular Assist DevicesThis policy describes Blue Cross Blue Shield of Louisiana coverage criteria for total artificial hearts (TAHs), implantable ventricular assist devices (VADs), and percutaneous VADs, including indications for destination therapy, bridge to transplant, post-cardiotomy/bridge to recovery, and percutaneous devices for cardiogenic shock. It applies to all products administered or underwritten by the Company.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-07-01Total Artificial Hearts and Percutaneous Ventricular Assist DevicesMedical policy governing coverage criteria for total artificial hearts (TAHs) and percutaneous ventricular assist devices (pVADs) for members of Blue Cross Blue Shield - Louisiana across applicable products when benefits and medical necessity criteria are met.All blue cross blue shield - louisiana updates
- Coverage CriteriaReimbursement/Payment PolicyEff. 2026-07-01Wound Care SuppliesDefines coverage, medical necessity criteria, and usage guidance for wound care dressings and related supplies for members of Blue Cross and Blue Shield of Louisiana and HMO Louisiana, Inc.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-07-01bevacizumab ProductsPolicy MA-214 governs coverage and medical necessity criteria for bevacizumab and its biosimilars for members of Blue Cross Blue Shield - Louisiana, including Medicare Advantage members, when benefits and medical necessity criteria are met.All blue cross blue shield - louisiana updates
- Coverage CriteriaClinical/Medical PolicyEff. 2026-07-01tocilizumab intravenous ProductsMedical policy governing coverage eligibility and clinical criteria for intravenous tocilizumab products (including Actemra and listed biosimilars) for multiple indications; applies to Blue Cross Blue Shield - Louisiana members and providers administering these products.All blue cross blue shield - louisiana updates
- Coverage CriteriaReimbursement/Payment PolicyEff. 2026-07-01upadacitinib (Rinvoq, Rinvoq LQ) coverageThis policy governs medical coverage and authorization criteria for upadacitinib (Rinvoq, Rinvoq LQ) across Blue Cross and Blue Shield of Louisiana products; it applies to members when benefits and medical necessity criteria are met.All blue cross blue shield - louisiana updates
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Tool Description
Search Blue Cross Blue Shield - Louisiana coverage criteria and medical necessity requirements across 21,000+ policies from 170+ payers.
Search a drug (“Wegovy”), a procedure (“knee replacement”), or a policy name, then filter by payer, specialty, policy type, or effective year. Or start from the largest publishers: UnitedHealthcare coverage criteria and Cigna coverage criteria.
Each result links the full policy page, which lists the clinical requirements, covered codes, and effective dates from the source document.
Pair a criteria search with the prior authorization lookup for approval requirements, the timely filing lookup for claim deadlines, the live policy updates feed for the newest payer publications, and payer profiles for contacts and coverage context.
FAQ
Coverage criteria are the specific clinical requirements a payer sets for covering a drug, procedure, or service: diagnoses, symptom duration, prior treatments tried, age limits, and documentation. They are published inside medical policies and clinical criteria documents, and a claim or authorization that does not meet them is denied as not medically necessary.
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