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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 |
|---|---|---|---|---|---|
| 11.001.006 | Testing for Helicobacter pylori Infection | Feb 21, 2023 | Policy Archived | Urea breath testing or fecal antigen testing may be considered medically necessary as part of the workup of... | Ver |
| 11.001.007 | Identification of Microorganisms Using Nucleic Acid Probes | Jul 16, 2024 | Jul 20, 2025 | The use of nucleic acid testing using a direct or amplified probe technique (without quantification of viral... | Ver |
| 11.001.009 | Noninvasine Techniques for the Evaluation and Monitoring of Patients with Chronic Liver Disease | Dec 13, 2023 | Dec 20, 2024 | A single fibrosure multianalyte assay may be considered medically necessary for the evaluation of patients... | Ver |
| 11.001.010 | ALFA-FETOPROTEI EN LA DETECCION DE CANCER HEPATOCELULAR | May 12, 2016 | Policy Archived | El alfa-fetoproteína para detección de cáncer hepatocelular no se considera para... | Ver |
| 11.001.011 | Serum Biomarker Human Epididymis Protein 4 | Jan 19, 2024 | Jan 20, 2025 | Measurement of human epididymis protein 4 is investigational for all indications.... | Ver |
| 11.001.012 | JAK2, MPL, and CALR, Testing for Myeloproliferative Neoplasms | Sep 12, 2023 | Sep 20, 2024 | Jak2 testing may be considered medically necessary in the diagnosis of individuals presenting with... | Ver |
| 11.001.013 | Urinary Biomarkers for Cancer Screening, Diagnosis, and Surveillance | Jan 09, 2024 | Jan 20, 2025 | The use of urinary tumor markers is considered investigational in the screening, diagnosis of, and... | Ver |
| 11.001.015 | Cardiovascular Risk Panels | Feb 09, 2024 | Retired | Cardiovascular disease risk panels, consisting of multiple individual biomarkers intended to assess cardiac... | 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 20, 2023 | Dec 20, 2024 | 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 |
| 11.001.019 | Rapid Flu Tests in the Outpatient Setting | Apr 30, 2019 | Policy Archived | In the outpatient setting rapid flu tests may be considered medically necessary as a technique to guide... | 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 04, 2024 | Jan 20, 2025 | 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 03, 2024 | Jan 20, 2025 | 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 |
