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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 |
|---|---|---|---|---|---|
| 11.001.032 | Evaluation of Biomarkers for Alzheimer Disease | Jul 18, 2024 | Nov 20, 2024 | 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 09, 2024 | Feb 20, 2025 | 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 04, 2024 | Jan 20, 2025 | Fecal analysis of the following components is considered investigational as a diagnostic test for the... | Ver |
| 11.001.035 | Measurement of Lipoprotein-Associated Phospholipase A2 in the Assessment of Cardiovascular Risk | Feb 09, 2024 | Retired | Measurement of lipoprotein-associated phospholipase a2 is... | Ver |
| 11.001.036 | Quantitative Assay for Measurement of HER2 Total Protein Expression and HER2 | Jan 19, 2021 | Policy Archived | The assessment of human epidermal growth factor receptor 2 (her2) status by quantitative total her2 protein... | Ver |
| 11.001.037 | Intracellular Micronutrient Analysis | Jan 19, 2024 | Jan 20, 2025 | Intracellular micronutrient panel testing is... | Ver |
| 11.001.038 | Multitarget Polymerase Chain traction Testing for Diagnosis of Bacterial Vaginosis | Jul 17, 2024 | Policy Archived | Multitarget polymerase chain reaction testing for the diagnosis of bacterial vaginosis is... | Ver |
| 11.001.039 | Nutrient/Nutritional Panel Testing | Jan 08, 2024 | Jan 20, 2025 | Nutrient/nutritional panel testing is considered investigational for all indications including but not... | Ver |
| 11.001.040 | Testing Serum Vitamin D Levels | Jan 15, 2024 | Jan 20, 2025 | Testing vitamin d levels in individuals with signs and/or symptoms of vitamin d deficiency or toxicity (see... | Ver |
| 11.001.041 | Drug Testing in Pain Management and Substance Use Disorder Treatment | Dec 11, 2023 | Dec 20, 2024 | In outpatient pain management, presumptive (i.e. immunoassay) drug testing may be considered medically... | Ver |
| 11.001.042 | Fecal Calprotectin Testing | Jan 04, 2024 | Jan 20, 2025 | Fecal calprotectin testing may be considered medically necessary for the evaluation of individuals when the... | Ver |
| 11.001.044 | Antigen Leukocyte Antibody Test | Nov 15, 2023 | Nov 20, 2024 | The antigen leukocyte antibody test is considered investigational for all... | Ver |
| 11.001.046 | Maternal Serum Biomarkers for Prediction of Adverse Obstetric Outcomes | Mar 19, 2024 | Mar 20, 2025 | The use of maternal serum biomarker tests with or without additional algorithmic analysis for prediction of... | Ver |
| 11.001.047 | Multicancer Early Detection Testing | Jul 19, 2024 | Jul 20, 2025 | The use of multicancer early detection (mced) tests (e.g., galleri) is considered investigational for cancer... | Ver |
| 11.002.001 | Systems Pathology in Prostate Cancer | Dec 10, 2020 | Policy Archived | Use of tests utilizing systems pathology that include cellular and biologic features of a tumor is considered... | Ver |
| 11.002.003 | Molecular Testing for the Management of Pancreatic Cysts, Barrett Esophagus, and Solid Pancreaticobiliary Lesions | Aug 16, 2023 | Aug 20, 2024 | Molecular testing using the pathfindertg system is considered investigational for all indications including... | Ver |
| 11.002.004 | Cervical Cancer Screening Technologies With Pap and HPV | Apr 28, 2022 | Policy Archived | The following refers to average-risk asymptomatic women aged 21 to 65: preparation of papanicolaou (pap)... | Ver |
| 11.003.001 | Laboratory Tests Post Transplant and for Heart Failure | Nov 16, 2023 | Nov 20, 2024 | The use of the presage st2 assay to evaluate the prognosis of individuals diagnosed with chronic heart... | Ver |
| 11.003.002 | Genetic Testing for Predisposition to Inherited Hypertrophic Cardiomyopathy | Apr 15, 2024 | Apr 20, 2025 | Genetic testing for predisposition to hypertrophic cardiomyopathy may be considered medically necessary for... | Ver |
| 11.003.003 | Multimarker Serum Testing Related to Ovarian Cancer | Jan 19, 2024 | Jan 20, 2025 | All uses of the ova1, overa, and roma tests are investigational, including but not limited to:... | Ver |
