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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 |
|---|---|---|---|---|---|
| 11.003.015 | Gene Expression Profile Testing and Circulating Tumor DNA Testing for Predicting Recurrence in Colon Cancer | Sep 18, 2024 | Sep 20, 2025 | Gene expression assays for determining the prognosis of stage ii or iii colon cancer following surgery are... | Ver |
| 11.003.016 | Genetic Testing for PTEN Hamartoma Tumor Syndrome | Mar 08, 2024 | Mar 20, 2025 | The pten hamartoma tumor syndrome (phts) includes several syndromes with heterogeneous clinical symptoms,... | Ver |
| 11.003.017 | Genetic Testing for Hereditary Hearing Loss | May 12, 2024 | May 20, 2025 | Hearing loss is a common birth defect. approximately 1 in 500 newborns in developed countries is affected by... | Ver |
| 11.003.018 | Chromosomal Microarray Testing for the Evaluation of Pregnancy Loss | Sep 19, 2024 | Sep 20, 2025 | Chromosomal microarray testing of fetal tissue may be considered medically necessary for the evaluation of... | Ver |
| 11.003.020 | Genetic Testing for Lactase Insufficiency | Jul 17, 2024 | Policy Archived | Genetic testing of adults with suspected lactase insufficiency is proposed as an alternative to current... | Ver |
| 11.003.021 | Gene Expression Testing in the Evaluation of Patients with Stable Ischemic Heart Disease | Apr 20, 2021 | Policy Archived | Gene expression testing in the evaluation of patients with stable ischemic heart disease is... | Ver |
| 11.003.022 | Genetic Testing for Li-Fraumeni Syndrome | Aug 20, 2024 | Aug 20, 2025 | Genetic testing for tp53 may be considered medically necessary to confirm a diagnosis of li-fraumeni syndrome... | Ver |
| 11.003.023 | General Approach to Evaluating the Utility of Genetic Panels | Jan 21, 2025 | Jan 20, 2026 | Genetic panels that use next-generation sequencing or chromosomal microarray analysis, and are classified in... | Ver |
| 11.003.025 | Genetic Testing for Developmental Delay/Intellectual Disability, Autism Spectrum Disorder, and Congenital Anomalies | Nov 22, 2024 | Nov 20, 2025 | Chromosomal microarray analysis may be considered medically necessary as first-line testing in the initial... | Ver |
| 11.003.026 | Comprehensive Genomic Profiling for Selecting Targeted Cancer Therapies | Nov 22, 2024 | Nov 20, 2025 | The use of comprehensive genomic profiling for selecting targeted cancer treatment is considered... | Ver |
| 11.003.027 | Germline Genetic Testing for Gene Variants Associated With Breast Cancer in Individuals at High Breast Cancer Risk (CHEK2, ATM, and BARD1) | Sep 12, 2024 | Sep 20, 2025 | Testing for chek2, atm, and bard1 variants in the assessment of breast cancer risk is considered... | Ver |
| 11.003.028 | Genetic Testing for Lynch Syndrome and Other Inherited Colon Cancer Syndromes | Dec 05, 2024 | Oct 20, 2025 | Apc testing genetic testing of the apc gene may be considered medically necessary in the following... | Ver |
| 11.003.029 | Epithelial Cell Cytology in Breast Cancer Risk Assesment and High-Risk Patient Management (Ductal Lavage and Suction Collection Systems) | May 20, 2019 | Policy Archived | Cytologic analysis of epithelial cells from nipple aspirations as a technique to assess breast cancer risk... | Ver |
| 11.003.030 | Germline Genetic Testing for Hereditary Breast/Ovarian Cancer Syndrome and Other High-Risk Cancers (BRCA1, BRCA2, PALB2) | Feb 10, 2025 | Sep 20, 2025 | Genetic testing should be performed in a setting that has suitably trained health care providers who can give... | Ver |
| 11.003.031 | Genetic Testing for Hereditary Hemochromatosis | Jul 10, 2024 | Policy Archived | Genetic testing for human hemochromatosis (hfe) gene variants may be considered medically necessary in an... | Ver |
| 11.003.032 | Analysis of Human DNA or RNA in Stool Samples as a Technique for Colorectal Cancer Screening | Jan 20, 2025 | Jan 20, 2026 | Dna or rna analysis of stool samples can be considered medically necessary as a screening technique for... | Ver |
| 11.003.033 | ALISIS DE LOS PATRONES PROTEOMICOS PARA IDENTIFICACION TEMPRA DEL CÁNCER DE OVARIO | May 12, 2016 | Policy Archived | El análisis de patrones proteómicos en el suero como cernimiento y detección de cáncer de ovario no se... | Ver |
| 11.003.034 | Genetic and Protein Biomarkers for the Diagnosis and Cancer Risk Assessment of Prostate Cancer | Dec 20, 2024 | Dec 20, 2025 | The following genetic and protein biomarkers for the diagnosis of prostate cancer are... | Ver |
| 11.003.035 | Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer | Dec 06, 2024 | Dec 20, 2025 | The use of the 21-gene reverse transcriptase-polymerase chain reaction (rt-pcr) assay (ie, oncotype dx),... | Ver |
| 11.003.036 | Genetic Testing for Familial Cutaneous Malignant Melanoma | Apr 15, 2024 | Apr 20, 2025 | Genetic testing for genes associated with familial cutaneous malignant melanoma or associated with... | Ver |
