Carelon Medical Benefits Management clinical appropriateness guidelines and cancer treatment pathways

Home 9 Author archive for dlamm

Sacroiliac Joint Fusion 2025-11-15 updated 2026-01-01

Link to PDF Status: Reaffirmed Effective Date: 11/15/2025 Doc ID: MSK05-1125.1-RUC0126 Last Review Date: 01/29/2026 Approval and implementation dates for specific health plans may vary. Please consult the applicable health plan for more details. Clinical...

Somatic Tumor Testing 2025-11-15 updated 2026-04-01

Link to PDF Status: Updated codes 04/01/2026 Effective Date: 11/15/2025 Doc ID: GEN02-1125.3-UC0426 Last Review Date: 04/21/2025 Approval and implementation dates for specific health plans may vary. Please consult the applicable health plan for more details. Clinical...