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The Policy Bulletins listed below represent our catalogue of medical and claim payment policies. If you are looking for a specific type of policy, use the menu on the right to select a category and narrow your search.
For information about policy numbers click
here.
For information about medical policies, the technology evaluation process, and claim payment policies click
here.
Policy #
Policy Bulletin Title
06.02.29
AlloMap™ Molecular Expression Testing for Heart Transplant Rejection
06.03.04g
Apheresis Therapy
06.02.27e
Assays of Genetic Expression in Tumor Tissue for Breast Cancer Prognosis
06.03.05d
Autologous Blood Services (Collection, Storage, Transfusion, and Perioperative Salvage)
06.00.01d
Computer Analysis and Generation of Automated Data in Conjunction with Diagnostic Studies
06.02.04c
Fetal Fibronectin Enzyme (fFN) Immunoassay
06.02.31a
Genetic Testing for Congenital Long QT Syndrome
06.02.06k
Genetic Testing for Inherited Breast Cancer 1 (BRCA1) and Breast Cancer 2 (BRCA2) Mutations
06.02.10h
Genetic Testing for Inherited Susceptibility to Colon Cancer and Microsatellite Instability Testing (Familial Adenomatous Polyposis and Lynch Syndrome)
06.02.35
Genetic Testing
06.02.09d
Human Immunodeficiency Virus (HIV) Genotyping and Phenotyping
06.02.26b
In Vitro Allergy Testing
06.02.14d
In Vitro Chemosensitivity and Chemoresistance Assays
06.02.01d
Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Treatment
06.02.30
Pharmacogenetic Testing to Determine Drug Sensitivity
06.02.18f
Pharmacogenetics and Metabolite Monitoring Using Azathioprine (AZA)/6-Mercaptopurine (6-MP) Therapy
06.02.24e
Preimplantation Genetic Diagnosis (PGD) Testing
06.02.17b
Serodiagnosis of Inflammatory Bowel Disease (IBD)
06.02.32
The 12-gene Expression Assay (Oncotype DX® colon cancer test) for Predicting Recurrence in Colon Cancer
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