Carelon Medical Benefits Management clinical appropriateness guidelines and cancer treatment pathways

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Prenatal Screening using Cell-free DNA 2025-09-20

Link to PDF Status: Revised Effective Date: 09/20/2025 Doc ID: GEN04-0925.1 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...

Hereditary Cancer Testing 2025-03-23

Link to PDF Status: Revised Effective Date: 03/23/2025 Doc ID: GEN01-0325.1 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...

Somatic Tumor Testing 2025-03-23 updated 2025-04-01

Link to PDF Status: Updated codes 04/01/2025 Effective Date: 03/23/2025 Doc ID: GEN02-0325.1-UC0425 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...