Carelon Medical Benefits Management clinical appropriateness guidelines and cancer treatment pathways

Home 9 Author archive for dlamm

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

Status: Updated codes 01/01/2026 Effective Date: 11/15/2025 Doc ID: GEN02-1125.3-UC0126 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...

Hereditary Cancer Testing 2025-03-23 updated 2026-01-01

Link to PDF Status: Updated codes 01/01/2026 Effective Date: 03/23/2025 Doc ID: GEN01-0325.1-UC0126 Last Review Date: 01/30/2025 Approval and implementation dates for specific health plans may vary. Please consult the applicable health plan for more details. Clinical...

Sacroiliac Joint Fusion 2025-11-15

Link to PDF Status: Revised Effective Date: 11/15/2025 Doc ID: MSK05-1125.1 Last Review Date: 01/30/2025 Approval and implementation dates for specific health plans may vary. Please consult the applicable health plan for more details. Clinical Appropriateness...

Joint Surgery 2025-11-15

Link to PDF Status: Revised Effective Date: 11/15/2025 Doc ID: MSK02-1125.1 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 Appropriateness...

Somatic Tumor Testing 2025-11-15

Link to PDF Status: Revised Effective Date: 11/15/2025 Doc ID: GEN02-1125.3 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 Appropriateness...