Carelon Medical Benefits Management clinical appropriateness guidelines and cancer treatment pathways

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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...

Spine Surgery 2025-11-15 [updated 2026-01-01]

Link to PDF Status: Updated codes 01/01/2026 Effective Date: 11/15/2025 Doc ID: MSK03-1125.1-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...

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

Link to PDF 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...