Clinical Coverage/Medical Policy Updates
QualChoice updates a select number of clinical coverage policies each month, ensuring the reviewal of all policies on an annual basis.
CG - Oncology Cancer Screening (PDF)
CG - Pharmacogenetics 2025.1 Version B (PDF)
CP.MP.101 - Donor Lymphocyte Infusion (PDF)
CP.MP.160 - Implantable Wireless Pulmonary Artery Pressure Monitoring (PDF)
CP.MP.170 - Nerve Blocks and Neurolysis for Pain Management (PDF)
CP.MP.246 - Pediatric Kidney Transplant (PDF)
CP.MP.163 - Total Parenteral Nutrition and Intradialytic Parenteral Nutrition (PDF)
V1.2025 - CG Testing: Aortopathies and Connective Tissue Disorders (PDF)
V1.2025 - CG Testing: Cardiac Disorders (PDF)
V1.2025 - CG Testing: Dermatologic Conditions (PDF)
V1.2025 - CG Testing: Epilepsy, Neurodegenerative, and Neuromuscular Conditions (PDF)
V1.2025 - CG Testing: Exome and Genome Sequencing for the Diagnosis of Genetic Disorders (PDF)
V1.2025 - CG Testing: Eye Disorders (PDF)
V1.2025 - CG Testing: General Approach to Genetic and Molecular Testing (PDF)
V1.2025 - CG Testing: Hearing Loss (PDF)
V1.2025 - CG Testing: Hematologic Conditions Non-Cancerous (PDF)
V1.2025 - CG Testing: Hereditary Cancer Susceptibility (PDF)
V1.2025 - CG Testing: Immune, Autoimmune, and Rheumatoid Disorders (PDF)
V1.2025 - CG Testing: Kidney Disorders (PDF)
V1.2025 - CG Testing: Lung Disorders (PDF)
V1.2025 - CG Testing: Metabolic, Endocrine, and Mitochondrial Disorders (PDF)
V1.2025 - CG Testing: Multisystem Inherited Disorders, Intellectual Disability, and Developmental Delay (PDF)
V1.2025 - CG Testing: Prenatal Cell-Free DNA Testing (PDF)
V1.2025 - CG Oncology: Algorithmic Testing (PDF)
V1.2025 - CG Oncology: Cancer Screening AR specifc version (PDF)
V1.2025 - CG Oncology: Circulating Tumor DNA and Circulating Tumor Cells (Liquid Biopsy) (PDF)
V1.2025 - CG Oncology: Cytogenetic Testing (PDF)
V1.2025 - CG Oncology: Molecular Analysis of Solid Tumors and Hematologic Malignancies (PDF)
V1.2025 - CG Testing: Preimplantation Genetic Testing (PDF)
V1.2025 - CG Testing: Prenatal and Preconception Carrier Screening (PDF)
V1.2025 - CG Testing: Prenatal Diagnosis (via Amniocentesis, CVS, or PUBS) and Pregnancy Loss (PDF)
V2.2024 - CG Testing: Skeletal Dysplasia and Rare Bone Disorders (PDF)
V1.2025 - CG Testing: Gastroenterologic Disorders Non-Cancerous (PDF)
V1.2025 - CG Testing: Pharmacogenetics (Version B) (PDF)
V1.2025 - CG Testing: Aortopathies and Connective Tissue Disorders (PDF)
CG - Pharmacogenetics 2025.1 Version B (PDF)
CP.MP.101 - Donor Lymphocyte Infusion (PDF)
CP.MP.160 - Implantable Wireless Pulmonary Artery Pressure Monitoring (PDF)
CP.MP.170 - Nerve Blocks and Neurolysis for Pain Management (PDF)
CP.MP.246 - Pediatric Kidney Transplant (PDF)
CP.MP.163 - Total Parenteral Nutrition and Intradialytic Parenteral Nutrition (PDF)
V1.2025 - CG Testing: Aortopathies and Connective Tissue Disorders (PDF)
V1.2025 - CG Testing: Cardiac Disorders (PDF)
V1.2025 - CG Testing: Dermatologic Conditions (PDF)
V1.2025 - CG Testing: Epilepsy, Neurodegenerative, and Neuromuscular Conditions (PDF)
V1.2025 - CG Testing: Exome and Genome Sequencing for the Diagnosis of Genetic Disorders (PDF)
V1.2025 - CG Testing: Eye Disorders (PDF)
V1.2025 - CG Testing: General Approach to Genetic and Molecular Testing (PDF)
V1.2025 - CG Testing: Hearing Loss (PDF)
V1.2025 - CG Testing: Hematologic Conditions Non-Cancerous (PDF)
V1.2025 - CG Testing: Hereditary Cancer Susceptibility (PDF)
V1.2025 - CG Testing: Immune, Autoimmune, and Rheumatoid Disorders (PDF)
V1.2025 - CG Testing: Kidney Disorders (PDF)
V1.2025 - CG Testing: Lung Disorders (PDF)
V1.2025 - CG Testing: Metabolic, Endocrine, and Mitochondrial Disorders (PDF)
V1.2025 - CG Testing: Multisystem Inherited Disorders, Intellectual Disability, and Developmental Delay (PDF)
V1.2025 - CG Testing: Prenatal Cell-Free DNA Testing (PDF)
V1.2025 - CG Oncology: Algorithmic Testing (PDF)
V1.2025 - CG Oncology: Cancer Screening AR specifc version (PDF)
V1.2025 - CG Oncology: Circulating Tumor DNA and Circulating Tumor Cells (Liquid Biopsy) (PDF)
V1.2025 - CG Oncology: Cytogenetic Testing (PDF)
V1.2025 - CG Oncology: Molecular Analysis of Solid Tumors and Hematologic Malignancies (PDF)
V1.2025 - CG Testing: Preimplantation Genetic Testing (PDF)
V1.2025 - CG Testing: Prenatal and Preconception Carrier Screening (PDF)
V1.2025 - CG Testing: Prenatal Diagnosis (via Amniocentesis, CVS, or PUBS) and Pregnancy Loss (PDF)
V2.2024 - CG Testing: Skeletal Dysplasia and Rare Bone Disorders (PDF)
V1.2025 - CG Testing: Gastroenterologic Disorders Non-Cancerous (PDF)
V1.2025 - CG Testing: Pharmacogenetics (Version B) (PDF)
V1.2025 - CG Testing: Aortopathies and Connective Tissue Disorders (PDF)
CP.MP.113 - Holter Monitors (PDF)
CP.MP.121 - Homocysteine Testing (PDF)
CP.MP.142 - Urinary Incontinence Devices and Treatments (PDF)
CP.MP.180 - Implantable Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea (PDF)
CP.MP.181 - PCR Respiratory Viral Panel Testing (PDF)
CP.MP.62 - Hyperhidrosis Treatments (PDF)
CP.MP.70 - Proton and Neutron Beam Therapies (PDF)
CP.MP.97 - Testing Select GU Conditions (PDF)
CP.MP.121 - Homocysteine Testing (PDF)
CP.MP.142 - Urinary Incontinence Devices and Treatments (PDF)
CP.MP.180 - Implantable Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea (PDF)
CP.MP.181 - PCR Respiratory Viral Panel Testing (PDF)
CP.MP.62 - Hyperhidrosis Treatments (PDF)
CP.MP.70 - Proton and Neutron Beam Therapies (PDF)
CP.MP.97 - Testing Select GU Conditions (PDF)
CP.BH.104 - Applied Behavior Analysis (PDF)
CP.BH.105 - Applied Behavioral Analysis Documentation Requirements (PDF)
CP.MP.82 - NICU Apnea Bradycardia Guidelines (PDF)
CP.MP.136 - Home Births (PDF)
CP.MP.102 - Pancreas Transplantation (PDF)
CP.MP.162 - Tandem Transplant (PDF)
CP.MP.163 - Total Parenteral Nutrition and Intradialytic Parenteral Nutrition (PDF)
CP.MP.40 - Gastric Electrical Stimulation (PDF)
CP.BH.105 - Applied Behavioral Analysis Documentation Requirements (PDF)
CP.MP.82 - NICU Apnea Bradycardia Guidelines (PDF)
CP.MP.136 - Home Births (PDF)
CP.MP.102 - Pancreas Transplantation (PDF)
CP.MP.162 - Tandem Transplant (PDF)
CP.MP.163 - Total Parenteral Nutrition and Intradialytic Parenteral Nutrition (PDF)
CP.MP.40 - Gastric Electrical Stimulation (PDF)
CP.MP.57 - Lung Transplantation (PDF)
CP.MP.69 - Intensity-Modulated Radiotherapy (PDF)
CP.MP.132 - Heart-Lung Transplant (PDF)
CP.BH.200 - Transcranial Magnetic Stimulation for Treatment of Major Depression (PDF)
CP.BH.201 - Deep Transcranial Magnetic Stimulation for Treatment of Obsessive Compulsive Disorder (PDF)
CP.MP.69 - Intensity-Modulated Radiotherapy (PDF)
CP.MP.132 - Heart-Lung Transplant (PDF)
CP.BH.200 - Transcranial Magnetic Stimulation for Treatment of Major Depression (PDF)
CP.BH.201 - Deep Transcranial Magnetic Stimulation for Treatment of Obsessive Compulsive Disorder (PDF)