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Notification of Policy Revisions Effective July 26, 2022 (Posted May 17, 2022)
Medical PolicyRevision
BRCA AHS - M2003 Reviewed by Avalon 1st Quarter 2022 CAB. Medical Director review 4/2022. Under “When Not Covered” section added new non-covered indication “genetic testing in minors < 18 years of age” is not medically necessary. Reformatted “When Covered” section. Note 5 removed. Updated policy guidelines and references. Notification 5/17/22 for effective date 7/26/22.
Immunopharmacologic Monitoring of Therapeutic Serum Antibodies AHS - G2105 Reviewed by Avalon 1st Quarter 2022 CAB – off cycle review. Updated When not Covered section to add “Reimbursement is not allowed for drug and/or antibody concentration testing for anti-TNF therapies in patients with spondyloarthritis, rheumatoid arthritis, psoriatic arthritis, and psoriasis.” References updated. Medical Director review 4/2022. Notification given 5/17/2022 for policy effective date 7/26/2022.
Thyroid Disease Testing AHS – G2045 Reviewed by Avalon 1st Quarter 2022 CAB. Description, Policy Guidelines and References updated. When Covered section reorganized and updated for clarity. Added “Reimbursement is not allowed for testing for thyrotropin-releasing hormone (TRH) for the evaluation of the cause of hyperthyroidism or hypothyroidism.” to When Not Covered section. Medical Director review 4/2022 Notification given on 5/17/2022 for effective date 7/26/2022.

 

 

 

 

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