MEG Payor Policies

Aetna

Magnetic Source Imaging/Magnetoencephalography

Policy Number: 0279

http://www.aetna.com/cpb/medical/data/200_299/0279.html

Anthem BlueCross BlueShield

Magnetic Source Imaging and Magnetoencephalography

Policy#: RAD.00019

www.anthem.com/ca/medicalpolicies/policies/mp_pw_a053261.htm

Anthem Blue Cross of California

Magnetic Source Imaging and Magnetoencephalography

Policy#: RAD.00019

http://www.anthem.com/ca/medicalpolicies/policies/mp_pw_a053261.htm

BlueCross BlueShield of Alabama

Magnetoencephalography/Magnetic Source Imaging

Policy #: 338

https://www.bcbsal.org/providers/policies/final/338.pdf

BlueShield of California

Magnetoencephalography/Magnetic Source Imaging

https://www.blueshieldca.com/provider/content_assets/documents/download/public/bscpolicy/Magnetoenceph_MSI.pdf

BlueCross BlueShield of Delaware

Magnetoencephalography/Magnetic Source Imaging

6.01.36

http://www.bcbsde.com/ProviderPolicies/public_site/6.01.36_Magnetoencephalography_and_Magnetic_Source_Imaging.htm

BlueCrossBlueShield of Florida

Magnetoencephalography/Magnetic Source Imaging

01-95805-16

http://mcgs.bcbsfl.com/

BlueCross BlueShield of Georgia

Magnetic Source Imaging and Magnetoencephalography

Policy#: RAD.00019

http://www.bcbsga.com/medicalpolicies/policies/mp_pw_a053261.htm

BlueCross BlueShield of Illinois

Magnetoencephalography (MEG) and Magnetic Source Imaging (MSI)

RAD601.038

http://medicalpolicy.hcsc.net/medicalpolicy/home?corpEntCd=IL1&path=/templatedata/medpolicies/POLICY/data/RADIOLOGY/RAD601.038_2011-11-15&ctype=POLICY&cat=Radiology#hlink

BlueCross BlueShield of Kansas

Magnetoencephalography/Magnetic Source Imaging

6.01.36

https://www.bcbskc.com/Public/Uploads/Medical_Policies/Radiology/05-11_6_Magnetoencephalography_Magnetic_Source_Imaging.pdf

BlueCross BlueShield of Minnesota

MAGNETOENCEPHALOGRAPHY / MAGNETIC SOURCE IMAGING

Policy Number: V-13

http://notes.bluecrossmn.com/web/medpolman.nsf/8178b1c14b1e9b6b8525624f0062fe9f/4272ea6a7996471c86256f88006b088a/$FILE/Magnetoencephalography%20-%20Magnetic%20Source%20Imaging.pdf

BlueCross BlueShield of Mississippi

Magnetoencephalography (MEG)/Magnetic Source Imaging

http://www.bcbsms.com/com/bcbsms/apps/PolicySearch/views/ViewPolicy.php?&blank&action=viewPolicy&noprint=yes&path=%2Fpolicy%2Femed%2FMagnetoencephalography_(MEG).html&keywords=%3C!123-321!%3E&source=emed&page=id=200&me=index.php

BlueCross BlueShield of North Carolina

Magnetoencephalography/Magnetic Source Imaging

https://www.bcbsnc.com/assets/services/public/pdfs/medicalpolicy/magnetoencephalography_magnetic_source_imaging.pdf

BlueCrossBlueShield of Idaho

Magnetoencephalography/Magnetic Source Imaging

Medical Policy 6.01.21

https://www.bcidaho.com/providers/medical_policies/rad/mp_60121.asp

BCBS TEC Assessment

Special Report: MEG and MSI for the Purpose of Presurgical Localization of Epileptic Lesions - A Challenge for Technology Evaluation

http://www.bcbs.com/blueresources/tec/vols/23/special-report-meg-and-msi.html

CareFirst BlueCross BlueShield

Magnetoencephalography/Magnetic Source Imaging

6.01.36

http://notesnet.carefirst.com/ecommerce/medicalpolicy.nsf/vwwebtablex?searchview&query=magnetoencephalography*&Start=1&Count=100&SearchOrder=4

Cigna Medical Coverage Policy

Magnetoencephalography (MEG)

Coverage Policy Number  0248

http://www.cigna.com/assets/docs/health-care-professionals/coverage_positions/mm_0248_coveragepositioncriteria_magnetoencephalography_meg.pdf

Empire BlueCrossBlueShield

Magnetic Source Imaging and Magnetoencephalography

Policy#: RAD.00019

http://www.empireblue.com/medicalpolicies/policies/mp_pw_a053261.htm

Highmark

Magnetoencephalography and Magnetic Source Imaging

Number M-13

https://secure.highmark.com/ldap/medicalpolicy/wpa-highmark/M-13-019.html

Oxford Health Plan

Magnetoencephalography and Magnetic Source Imaging For Specific Neurological Applications

Policy #: DIAGNOSTIC 029.7 T3

https://www.oxhp.com/secure/policy/magnetoencephalography_911.html

Premera Blue Cross

Magnetoencephalography/Magnetic Source Imaging

https://www.premera.com/stellent/groups/public/documents/medicalpolicy/cmi_003603.htm

Regence  (Oregon, Utah, Idaho and Washington)

Radiology Section - Magnetoencephalography/Magnetic Source Imaging (MSI)

Policy No: 22

http://blue.regence.com/trgmedpol/radiology/rad22.html

UnitedHealthcare

Magnetoencephalography and Magnetic Source Imaging for specific Neurological Applications

Policy Number: 2011T0172I

https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Policies%20and%20Protocols/Medical%20Policies/Medical%20Policies/Magnetoencephalography_and_Magnetic_Source_Imaging.pdf

Wellmark

Magnetoencephalography/Magnetic Source Imaging

6.01.36

https://bluepriority.wellmark.com/Provider/MedPoliciesAndAuthorizations/MedicalPolicies/policies/magnetoencephalography.aspx

Blue Cross Blue Shield Association policy #6.01.21

Magnetoencephalography for the purpose of determining the laterality of language function, as a substitute for the Wada test, in patients being prepared for surgery for epilepsy, brain tumors, and other indications requiring brain resection, may be considered medically necessary.

Magnetoencephalography/magnetic source imaging as part of the preoperative evaluation of patients with intractable epilepsy (seizures refractory to medical therapy) may be considered medically necessary when standard techniques, such as MRI, are inconclusive.

Magnetoencephalography/magnetic source imaging is considered investigational for all other indications.