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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 |
|---|---|---|---|---|---|
| 11.003.066 | Genetic Testing for Duchenne and Becker Muscular Dystrophy | Apr 17, 2024 | Apr 20, 2025 | Genetic testing for dmd gene variants may be considered medically necessary under the following... | Ver |
| 11.003.067 | Genotype-Guided Warfarin Dosing | Jul 08, 2024 | Jul 20, 2025 | Genotyping to determine cytochrome p450 2c9 (cyp2c9), p450 4f2 (cyp4f2), and vitamin k epoxide reductase... | Ver |
| 11.003.068 | Genetic Testing for the Diagnosis of Inherited Peripheral Neuropathies | Dec 16, 2024 | Feb 20, 2025 | Genetic testing is considered medically necessary when the diagnosis of an inherited peripheral motor or... | Ver |
| 11.003.069 | Analysis of MGMT Promoter Methylation in Malignant Gliomas | Jun 13, 2019 | Policy Archived | Methylation analysis of the o6-methylguanine dna methyltransferase (mgmt) gene promoter from glioma tumor... | Ver |
| 11.003.070 | Preimplantation Genetic Testing | Dec 06, 2024 | Sep 20, 2025 | Preimplantation genetic diagnosis may be considered medically necessary as an adjunct to in vitro... | Ver |
| 11.003.072 | Genetic Testing for Marfan Syndrome, Thoracic Aortic Aneurysms and Dissections, and Related Disorders | Mar 19, 2024 | Mar 20, 2025 | Marfan syndrome (mfs) is a systemic connective tissue disease (ctd) with a high degree of clinical... | Ver |
| 11.003.073 | Laboratory and Genetic Testing for Use of 5-Fluorouracil in Patients with Cancer | Apr 15, 2024 | Apr 20, 2025 | Assay testing for determining 5-fluorouracil area under the curve in order to adjust 5-fluorouracil dose for... | Ver |
| 11.003.075 | Proteomic Testing for Targeted Therapy in Non-Small-Cell Lung Cancer | Dec 06, 2024 | Dec 20, 2025 | The use of proteomic testing, including but not limited to the veristrat assay, is considered investigational... | Ver |
| 11.003.076 | Multibiomarker Disease Activity Blood Test for Rheumatoid Arthritis | Jul 19, 2024 | Jul 20, 2025 | The use of a multibiomarker disease activity score for rheumatoid arthritis (eg, vectra score) is... | Ver |
| 11.003.077 | LOS ENSAYOS DE VARIOS ALITOS CON EL ALISIS ALGORITMICO PARA PREDECIR EL RIESGO DE DABETES TIPO 2 | Oct 11, 2016 | Policy Archived | El uso de paneles de varios analitos con el análisis algorítmico (masa) para la predicción de la diabetes... | Ver |
| 11.003.078 | Noninvasive Prenatal Screening for Fetal Aneuploidies, Microdeletions, Single-Gene Disorders and Twin Zygosity Using Cell-Free Fetal DNA | Feb 03, 2025 | Sep 20, 2025 | Nucleic acid sequencing-based testing of maternal plasma to screen for trisomy 21, 18, and 13 may be... | Ver |
| 11.003.079 | Invasive Prenatal (Fetal) Diagnostic Testing | Sep 13, 2024 | Sep 20, 2025 | Chromosomal microarray testing in patients who are undergoing invasive diagnostic prenatal (fetal)... | Ver |
| 11.003.081 | Genetic Testing for Macular Degeneration | Apr 18, 2024 | Apr 20, 2025 | Genetic testing for macular degeneration is considered... | Ver |
| 11.003.082 | Genetic Testing for Facioscapulohumeral Muscular Dystrophy | Mar 15, 2024 | Mar 20, 2025 | Genetic testing for facioscapulohumeral muscular dystrophy may be considered medically necessary to confirm... | Ver |
| 11.003.083 | Genetic Testing for CHARGE Syndrome | Mar 15, 2024 | Mar 20, 2025 | Genetic testing for charge syndrome may be considered medically necessary to confirm a diagnosis in a... | Ver |
| 11.003.084 | Genetic Testing for Idiopathic Dilated Cardiomyopathy | Mar 15, 2024 | Mar 20, 2025 | Comprehensive genetic testing for individuals with signs or symptoms of dilated cardiomyopathy, which is... | Ver |
| 11.003.085 | Genetic Testing for Limb-Girdle Muscular Dystrophies | Jun 18, 2024 | Policy Archived | The limb-girdle muscular dystrophies are a genetically heterogeneous group of muscular dystrophies... | Ver |
| 11.003.086 | KIF6 Genotyping for Predicting Cardiovascular Risk | Aug 20, 2021 | Policy Archived | Kif6 genotyping is considered investigational for predicting cardiovascular risk and/or the effectiveness of... | Ver |
| 11.003.087 | Molecular Testing in the Management of Pulmonary Nodules | Jun 18, 2024 | Jun 20, 2025 | Plasma-based proteomic screening, including but not limited to nodify xl2® (bdx-xl2), nodify cdt®, and... | Ver |
| 11.003.088 | Molecular Testing for Chronic Heart Failure and Heart Transplant | Jun 17, 2021 | Policy Archived | The use of the presage st2 assay to evaluate the prognosis of patients diagnosed with chronic heart failure... | Ver |
