Medical Policies

Medical policies are documents that define the plan coverage for technologies, procedures and treatments. The statements of medical necessity in the policies, about whether a technology, procedure, treatment, supply, equipment, drug or other service improves the health outcome of the population for which said technology or treatment was designed are based on scientific evidence, clinical studies and professional opinions from our providers and recognized medical organizations.

Each document displayed on this website is provided for informational purposes only and is not an authorization, explanation of benefits, or contract. Receiving benefits is subject to satisfaction of all terms and conditions of coverage. Medical technology is constantly changing, and we reserve the right to periodically review and update our policies.

Medical Policies table

ID Title Review Description Access
11.001.006 Prueba de aliento de urea en el diagnóstico Helicobacter Pylori Feb 2025 Several invasive and non-invasive tests are available for the detection of helicobacter pylori infection in... View
11.001.007 Identification Of Microorganisms Using Nucleic Acid Probes Feb 2026 Nucleic acid probes are available for the identification of a wide variety of microorganisms. nucleic acid... View
11.001.008 Anticuerpo para el diagnóstico de las enfermedades inflamatoria del intestino Sep 2016 ... View
11.001.009 Noninvasine Techniques For The Evaluation And Monitoring Of Patients With Chronic Liver Disease Nov 2025 Noninvasive techniques to monitor liver fibrosis are being investigated as alternatives to liver biopsy in... View
11.001.010 Alfa-fetoproteina en la deteccion de cancer hepatocelular May 2016 ... View
11.001.011 Serum Biomarker Human Epididymis Protein 4 Jan 2026 Human epididymis protein 4 (he4) is a novel biomarker that has been cleared by the u.s. food and drug... View
11.001.012 Jak2 And Mpl, Testing For Myeloproliferative Neoplasms Sep 2025 Somatic (acquired) genetic variants in jak2, mpl, and calr genes have been implicated as the underlying... View
11.001.013 Urinary Biomarkers For Cancer Screening, Diagnosis, And Surveillance Jan 2026 The diagnosis of bladder cancer is generally made by cystoscopy and biopsy. bladder cancer has a very high... View
11.001.016 Serum Biomarker Tests For Multiple Sclerosis Jul 2025 Serum antibodies to polysaccharide-containing molecules, called glycans, and other serum biomarkers are... View
11.001.017 Pharmacogenetic Testing For Pain Management Feb 2026 While multiple pharmacologic therapies are available for the management of acute and chronic pain, there is a... View
11.001.018 Diagnóstico serológico de la enfermedad celiaca Sep 2016 ... View
11.001.020 Detection Of Circulating Tumor Cells In The Management Of Patients With Cancer May 2019 The prognosis of cancer patients is often determined by the occurrence of metastatic disease. studies have... View
11.001.021 Measurement Of Long-Chain Omega-3 Fatty Acids In Red Blood Cell Membranes As A Cardiac Risk Factor Jul 2025 Epidemiologic studies have reported that subjects who eat a diet high in fish have a reduced risk of sudden... View
11.001.022 Homocysteine Testing In The Screening, Diagnosis, And Management Of Cardiovascular Disease And Venous Thromboembolic Disease Jan 2026 Homocysteine is an amino acid that has been evaluated as a potential marker of cardiovascular disease (cvd)... View
11.001.023 Procalcitonin As A Marker In The Systemic Inflammatory Response Nov 2021 Severe infection and sepsis are frequent causes of morbidity and mortality in intensive care units. infection... View
11.001.024 Laboratory Testing For Hiv Tropism Jan 2021 Hiv tropism testing can determine the predominant coreceptor protein used by hiv to infect target cells.... View
11.001.026 Genotipo y Fenotipo en HIV May 2016 ... View
11.001.027 Immune Cell Function Assay Jan 2026 Careful monitoring of lifelong immunosuppression is required to ensure the long-term viability of solid organ... View
11.001.029 Prueba fibronectina fetal May 2016 ... View
11.001.032 Evaluation of Biomarkers for Alzheimer Disease Nov 2025 Biochemical changes associated with the pathophysiology of alzheimer disease (ad) are being evaluated to aid... View