Carelon Medical Benefits Management clinical appropriateness guidelines and cancer treatment pathways

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Genetic Testing for Inherited Conditions 2025-03-23

Link to PDF Status: Revised Effective Date: 03/23/2025 Doc ID: GEN06-0325.1 Last Review Date: 07/16/2024 Approval and implementation dates for specific health plans may vary. Please consult the applicable health plan for more details. Clinical Appropriateness...

Small Joint Surgery 2024-11-17

Link to PDF Status: Revised Effective Date: 11/17/2024 Doc ID: MSK06-1124.1 Last Review Date: 04/15/2024 Approval and implementation dates for specific health plans may vary. Please consult the applicable health plan for more details. Clinical Appropriateness...

Joint Surgery 2024-11-17

Link to PDF Status: Revised Effective Date: 11/17/2024 Doc ID: MSK02-1124.1 Last Review Date: 07/16/2024 Approval and implementation dates for specific health plans may vary. Please consult the applicable health plan for more details. Clinical Appropriateness...

Joint Surgery 2024-11-17 updated 2025-01-01

Link to PDF Status: Updated codes 01/01/2025 Effective Date: 11/17/2024 Doc ID: MSK02-1124.1-UC0125 Last Review Date: 07/16/2024 Approval and implementation dates for specific health plans may vary. Please consult the applicable health plan for more details. Clinical...

Somatic Tumor Testing 2024-11-17 updated 2025-01-01

Link to PDF Status: Updated codes 01/01/2025 Effective Date: 11/17/2024 Doc ID: GEN02-1124.4-UC0125 Last Review Date: 10/28/2024 Approval and implementation dates for specific health plans may vary. Please consult the applicable health plan for more details. Clinical...