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| Medical Policy | Revision |
|---|---|
| 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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