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
11.003.047 Gene Expression-Based Assays For Cancers Of Unknown Primary May 2026 Cancers of unknown primary represent 3% to 4% of cancers diagnosed in the united states. these cancers are... View
11.003.048 Carrier Screening For Genetic Diseases Oct 2025 Carrier screening is performed to identify individuals at risk of having offspring with inherited recessive... View
11.003.049 Genetic Testing For Diagnosis And Management Of Mental Health Conditions Aug 2026 Individual genes have been shown to be associated with the risk of psychiatric disorders and specific aspects... View
11.003.050 Genetic Testing For Epilepsy Mar 2026 Epilepsy is a disorder characterized by unprovoked seizures. it is a heterogeneous condition that encompasses... View
11.003.051 Gene Expression Profiling And Protein Biomarkers For Prostate Cancer Management Aug 2026 Gene expression profile analysis and protein biomarkers have been proposed as a means to risk-stratify... View
11.003.052 Molecular Markers In Fine Needle Aspirates Of The Thyroid Sep 2025 To determine which patients need thyroid resection, many physicians will perform a cytologic examination of... View
11.003.053 Whole Exome And Whole Genome Sequencing For Diagnosis Of Genetic Disorders Feb 2026 Whole exome sequencing (wes) sequences the portion of the genome that contains protein-coding dna, while... View
11.003.056 Genetic Testing For A Thalassemia Jul 2026 Alpha-thalassemia represents a group of clinical syndromes of varying severity characterized by hemolytic... View
11.003.057 Genetic Testing For Fanconi Anemia Jan 2026 Fanconi anemia (fa) is an inherited disorder characterized by congenital abnormalities, bone marrow failure,... View
11.003.059 Genetic Testing For Hereditary Pancreatitis Mar 2026 ... View
11.003.060 Genetic Testing For Flt3, Npm1, And Cebpa Variants In Cytogenetically Normal Acute Myeloid Leukemia Feb 2026 Treatment of acute myeloid leukemia (aml) is based on risk stratification, primarily related to age and tumor... View
11.003.061 Genotipado de Nucleótido único 9p21-polimorfismos de Predecir el Riesgo Oct 2016 ... View
11.003.062 General Approach To Genetic Testing Jan 2026 Commercially available genetic tests can perform a host of functions, such as providing a guided intervention... View
11.003.063 Bcr-Abl1 Testing In Chronic Myelogenous Leukjemia And Acute Lymphoblastic Leukemia Nov 2025 In the treatment of philadelphia chromosome-positive leukemias, various nucleic acid-based laboratory methods... View
11.003.064 Genetic Cancer Susceptibility Panels Using Next Generation Sequencing Feb 2026 Commercially available cancer susceptibility gene panels can test for multiple variants associated with a... View
11.003.066 Genetic Testing For Duchenne And Becker Muscular Dystrophy Apr 2026 Variants in the duchenne muscular dystrophy (dmd) gene, which encodes the protein dystrophin, may result in a... View
11.003.067 Genotype-Guided Warfarin Dosing Jul 2026 Using information about an individual's genotype may help in guiding warfarin dosing and could reduce... View
11.003.068 Genetic Testing For The Diagnosis Of Inherited Peripheral Neuropathies Feb 2026 The inherited peripheral neuropathies are a heterogeneous group of diseases that may be inherited in an... View
11.003.069 Analysis Of Mgmt Promoter Methylation In Malignant Gliomas Jun 2019 Testing for o6-methylguanine-dna methyltransferase (mgmt) gene promoter methylation has been proposed as a... View
11.003.070 Preimplantation Genetic Testing Sep 2025 Preimplantation genetic testing involves the analysis of biopsied cells as part of an assisted reproductive... View