by Kristin Fleming | Nov 17, 2025 | Current
Link to PDF Status: Updated codes 11/17/2024 Effective Date: 04/01/2023 Doc ID: CAR03-0423.1-UC1124 Last Review Date: 01/23/2024 Approval and implementation dates for specific health plans may vary. Please consult the applicable health plan for more details. Clinical...
by Kristin Fleming | Nov 6, 2025 | Current
Link to PDF Status: Revised Effective Date: 11/15/2025 Doc ID: SUR03-1125.1 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...
by Kristin Fleming | Oct 20, 2025 | Current
Link to PDF Status: Reaffirmed Effective Date: 12/30/2023 Doc ID: REH02-1223.1-R1025 Last Review Date: 10/09/2025 Approval and implementation dates for specific health plans may vary. Please consult the applicable health plan for more details. Clinical Appropriateness...
by Kristin Fleming | Oct 15, 2025 | Current
Link to PDF Status: Revised Effective Date: 11/15/2025 Doc ID: SDM01-1125.1 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...
by Kristin Fleming | Jul 28, 2025 | Archived
Archive Date: 01/01/2026 This document has been archived because it has outdated information. It is for historical information only and should not be consulted for clinical use. Current versions of guidelines are available on the Carelon Medical Benefits Management...
