Policy Bulletins
The Policy Bulletins listed below represent our catalogue of medical and claim payment policies. If you are looking for a specific type of policy, choose a category from the menu on the right. You may also use the search function in the top menu to search for policies by word or phrase.
 
   


Policy #
Policy Bulletin Title
06.02.29d
AlloMap™ Molecular Expression Testing for Heart Transplant Rejection (AmeriHealth Administrators)
06.03.04n
Apheresis Therapy
06.02.27l
Assays of Genetic Expression in Tumor Tissue for Breast Cancer Prognosis (AmeriHealth Administrators)
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06.02.54
Cobalamin (Vitamin B12), Folic Acid, and Homocysteine Testing
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06.02.52q
eviCore Lab Management Program (AmeriHealth)
06.02.04d
Fetal Fibronectin Enzyme (fFN) Immunoassay
06.02.31f
Genetic Testing for Congenital Long QT Syndrome (AmeriHealth Administrators)
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06.02.06q
Genetic Testing for Inherited Breast Cancer 1 (BRCA1) and Breast Cancer 2 (BRCA2) Mutations (AmeriHealth Administrators)
06.02.10q
Genetic Testing for Inherited Susceptibility to Colon Cancer and Microsatellite Instability Testing (Familial Adenomatous Polyposis and Lynch Syndrome) (AmeriHealth Administrators)
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06.02.35y
Genetic Testing (AmeriHealth Administrators)
06.02.50
GPS Cancer™ Testing by NantHealth
06.02.09g
Human Immunodeficiency Virus (HIV) Genotyping and Phenotyping (AmeriHealth Administrators)
06.02.37a
Immune Cell Function Assay
06.02.26d
In Vitro Allergy Testing
06.02.14i
In Vitro Chemosensitivity and Chemoresistance Assays
06.02.01j
Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Therapy
06.02.39d
Measurement of Serum Antibodies to and Measurement of Serum Levels of Biologics
06.02.36c
Molecular Testing for the Management of Pancreatic Cysts or Barrett's Esophagus (AmeriHealth Administrators)
06.02.32d
Multigene Expression Assays for Predicting Recurrence in Colon Cancer (AmeriHealth Administrators)
06.02.38d
Nerve Fiber Density Testing
06.02.47d
Noninvasive Prenatal Screening for Fetal Aneuploidies Using Cell-Free Fetal DNA (AmeriHealth Administrators)
06.02.56b
Noninvasive Techniques for the Evaluation and Monitoring of Individuals with Chronic Liver Disease
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06.02.30e
Pharmacogenetic Testing to Determine Drug Sensitivity (AmeriHealth Administrators)
06.02.18l
Pharmacogenetics and Metabolite Monitoring for Using Azathioprine (AZA)/6-Mercaptopurine (6-MP) Therapy (AmeriHealth Administrators)
06.02.24j
Preimplantation Genetic Testing (AmeriHealth Administrators)
06.02.44m
Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments
06.02.43b
Proteomic (Protein)-Based Testing for the Evaluation of Ovarian (Adnexal) Masses Using OVA1® Test and Risk of Ovarian Malignancy Algorithm (ROMA™)
06.02.17h
Serodiagnosis of Inflammatory Bowel Disease (IBD) and the Prometheus® IBD sgi Diagnostic™ Test
06.02.51c
Testing Serum Vitamin D Levels
06.02.55
Therapeutic Drug Monitoring for Antidepressants, Antipsychotics, or Antiepileptics
06.02.45
Vectra® DA Blood Test for Rheumatoid Arthritis
06.02.49b
VeriStrat® Testing for Targeted Therapy in Non-Small Cell Lung Cancer