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 |
|---|---|---|---|---|---|
| 11.003.057 | Genetic Testing for Fanconi Anemia | Jan 08, 2024 | Jan 20, 2025 | Genetic testing for the diagnosis of fanconi anemia may be considered medically necessary when the... | Ver |
| 11.003.059 | Genetic Testing for Hereditary Pancreatitis | Mar 14, 2023 | Mar 20, 2024 | Genetic testing for hereditary pancreatitis may be considered medically necessary for patients aged 18 years... | Ver |
| 11.003.060 | Genetic Testing for FLT3, NPM1, and CEBPA Variants in Cytogenetically Normal Acute Myeloid Leukemia | Feb 20, 2024 | Feb 20, 2025 | Genetic testing for flt3 internal tandem duplication (flt3-itd), npm1, andcebpa variants may be considered... | Ver |
| 11.003.062 | General Approach to Genetic Testing | Jan 09, 2024 | Jan 20, 2025 | Genetic testing classified in one of the categories below may be considered medically necessary when all... | Ver |
| 11.003.063 | BCR-ABL1 Testing in Chronic Myelogenous Leukemia and Acute Lymphoblastic Leukemia | Nov 15, 2023 | Nov 20, 2024 | Chronic myelogenous leukemia bcr-abl1 qualitative testing for the presence of the fusion gene may be... | Ver |
| 11.003.064 | Genetic Cancer Susceptibility Panels Using Next Generation Sequencing | Nov 16, 2023 | Nov 20, 2024 | General genetic cancer susceptibility panel testing is considered investigational; however, when the coverage... | Ver |
| 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 conditions:... | Ver |
| 11.003.067 | Genotype-Guided Warfarin Dosing | Jul 05, 2023 | Jul 20, 2024 | 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 | Feb 13, 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 | Sep 07, 2023 | Sep 20, 2024 | 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 | Apr 19, 2024 | Apr 20, 2025 | Individual genetic testing for the diagnosis of marfan syndrome, ehlers-danlos syndrome type iv, other... | 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, 2023 | Dec 20, 2024 | 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 18, 2023 | Jul 20, 2024 | 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 | Apr 15, 2024 | Apr 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 07, 2023 | Sep 20, 2024 | 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 |
