BlueCross BlueShield of Tennessee Medical Policy Manual

Gastroenterology

• Confocal Laser Endomicroscopy

• Cryosurgical Ablation of Solid Tumors

• Cutaneous Electrogastrography (EGG)

• Gastric Electrical Stimulation

• Genetic (Human Leukocyte Antigen) Testing for Celiac Disease

• Ingestible pH and Pressure Capsule

• Intestinal Transplantation

• Laparoscopic and Endoscopic Therapies for Gastroesophageal Reflux (GERD)

• Minimally Invasive Endoscopic Procedures for Weight Loss

• Noninvasive Imaging Techniques for Evaluation and Monitoring of Chronic Liver Diseases

• Pancreas/Pancreas-Kidney/Pancreatic Islet Cell Transplantation

• Plugs for Anal Fistula Repair

• Radioembolization for Primary Tumors and Metastatic Tumors to the Liver

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