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Políticas Médicas
Las políticas médicas son documentos que definen el reconocimiento de cubierta para tecnologías, procedimientos y tratamientos. Las declaraciones de necesidad médica en las políticas, sobre si una tecnología, procedimiento, tratamiento, suplido, equipo, medicamento u otro servicio mejora el resultado en la salud de la población para la cual dicha tecnología o tratamiento fue diseñado se basan en evidencia científica, estudios clínicos y opiniones profesionales de nuestros proveedores y de las organizaciones médicas reconocidas.
Cada documento desplegado en este sitio Web se provee con propósitos informativos solamente y no es una autorización, explicación de beneficios o un contrato. El recibir beneficios está sujeto a la satisfacción de todos los términos y condiciones de la cubierta. La tecnología médica cambia constantemente y nos reservamos el derecho de revisar y actualizar nuestras políticas periódicamente.
| ID | Título | Última Revisión | Siguiente Revisión | Descripción | Acceso |
|---|---|---|---|---|---|
| 11.001.013 | Urinary Biomarkers for Cancer Screening, Diagnosis, and Surveillance | Jan 21, 2025 | Jan 20, 2026 | The use of urinary tumor markers is considered investigational in the screening, diagnosis of, and... | Ver |
| 11.001.016 | Serum Biomarker Tests for Multiple Sclerosis | Jun 08, 2020 | Policy Archived | Serum biomarker tests for multiple sclerosis are considered investigational in all... | Ver |
| 11.001.017 | Pharmacogenetic Testing for Pain Management | Dec 26, 2024 | Dec 20, 2025 | Genetic testing for pain management is considered investigational for all indications (see policy guidelines... | Ver |
| 11.001.018 | DIAGNÓSTICO SEROLOGICO DE LA ENFERMEDAD CELIACA | Sep 21, 2016 | Policy Archived | La determinación serológica de anticuerpos (hla-dq2 y hla-dq8) de antigliandina y de anticuerpo... | Ver |
| 11.001.020 | Detection of Circulating Tumor Cells in the Management of Patients With Cancer | May 30, 2019 | May 30, 2020 | Detection and quantification of circulating tumor cells is considered investigational in the management of... | Ver |
| 11.001.021 | Measurement of Long-Chain Omega-3 Fatty Acids in Red Blood Cell Membranes as a Cardiac Risk Factor | May 22, 2019 | Policy Archived | Measurement of long-chain omega-3 fatty acids in red blood cell membranes, including but not limited to its... | Ver |
| 11.001.022 | Homocysteine Testing in the Screening, Diagnosis, and Management of Cardiovascular Disease and Venous Thromboembolic Disorders | Jan 08, 2025 | Jan 20, 2026 | Measurement of plasma levels of homocysteine is considered investigational in the screening, evaluation,... | Ver |
| 11.001.023 | PROCALCITONIN AS A MARKER IN THE SYSTEMIC INFLAMMATORY RESPONSE | Nov 10, 2021 | Policy Archived | The use of procalcitonin in the clinical setting is not considered for payment. clinical studies published... | Ver |
| 11.001.024 | Laboratory Testing for HIV Tropism | Jan 19, 2021 | Policy Archived | Hiv tropism testing (see policy guidelines section for testing methods) may be considered medically necessary... | Ver |
| 11.001.026 | GENOTIPO Y FENOTIPO EN HIV | May 16, 2016 | Policy Archived | Identificación de genotipo o fenotipo se considera para pago en pacientes que no han respondido a terapia... | Ver |
| 11.001.027 | Immune Cell Function Assay | Jan 08, 2025 | Jan 20, 2026 | Use of the immune cell function assay to monitor and predict immune function after solid organ... | Ver |
| 11.001.029 | PRUEBA FIBRONECTI FETAL (fFN) | May 16, 2016 | Policy Archived | El uso de la prueba de fibronectina fetal (ffn), se considera para pago en mujeres con embarazos sencillos o... | Ver |
| 11.001.032 | Evaluation of Biomarkers for Alzheimer Disease | Dec 10, 2024 | Nov 20, 2025 | Cerebrospinal fluid biomarker testing, including but not limited to amyloid beta peptides, tau protein, or... | Ver |
| 11.001.033 | Bone Turnover Markers for the Diagnosis and Management of Osteoporosis and Diseases Associated with High Bone Turnover | Feb 05, 2025 | Feb 20, 2026 | Measurement of bone turnover markers is considered investigational to determine fracture risk in patients... | Ver |
| 11.001.034 | Fecal Analysis in the Diagnosis of Intestinal Dysbiosis | Jan 08, 2025 | Jan 20, 2026 | Fecal analysis of the following components is considered investigational as a diagnostic test for the... | Ver |
| 11.001.036 | Quantitative Assay for Measurement of HER2 Total Protein Expression and HER2 | Jan 19, 2021 | Policy Archived | Novel assays that quantitatively measure total human epidermal growth factor receptor 2 (her2) protein... | Ver |
| 11.001.037 | Intracellular Micronutrient Analysis | Jan 08, 2025 | Jan 20, 2026 | Intracellular micronutrient panel testing is... | Ver |
| 11.001.038 | Summary | Jan 15, 2025 | Policy Archived | Multitarget polymerase chain reaction testing for the diagnosis of bacterial vaginosis is... | Ver |
| 11.001.039 | Nutrient/Nutritional Panel Testing | Jan 15, 2025 | Jan 20, 2026 | Nutrient/nutritional panel testing is considered investigational for all indications including but not... | Ver |
| 11.001.040 | Testing Serum Vitamin D Levels | Jan 15, 2025 | Jan 20, 2026 | Testing vitamin d levels in individuals with signs and/or symptoms of vitamin d deficiency or toxicity (see... | Ver |
