When services can be administered in various settings, the Company reserves the right to reimburse only those services that are furnished in the most appropriate and cost-effective setting that is appropriate to the member’s medical needs and condition. This decision is based on the member’s current medical condition and any required monitoring or additional services that may coincide with the delivery of this service.
This Medical Policy Bulletin document describes the status of medical technology at the time the document was developed. Since that time, new technology may have emerged or new medical literature may have been published. This Medical Policy Bulletin will be reviewed regularly and be updated as scientific and medical literature becomes available. For more information on how Medical Policy Bulletins are developed, go to the About This Site section of this Medical Policy Web site.
Policy: 06.02.09g:Human Immunodeficiency Virus (HIV) Genotyping and Phenotyping (Independence Administrators)
Policy: 06.02.10q:Genetic Testing for Inherited Susceptibility to Colon Cancer and Microsatellite Instability Testing (Familial Adenomatous Polyposis and Lynch Syndrome) (Independence Administrators)
Policy: 06.02.18k:Pharmacogenetics and Metabolite Monitoring for Using Azathioprine (AZA)/6-Mercaptopurine (6-MP) Therapy (Independence Administrators)
Policy: 06.02.24j:Preimplantation Genetic Testing (Independence Administrators)
Policy: 06.02.27l:Assays of Genetic Expression in Tumor Tissue for Breast Cancer Prognosis (Independence Administrators)
Policy: 06.02.29d:AlloMap™ Molecular Expression Testing for Heart Transplant Rejection (Independence Administrators)
Policy: 06.02.30e:Pharmacogenetic Testing to Determine Drug Sensitivity (Independence Administrators)
Policy: 06.02.31f:Genetic Testing for Congenital Long QT Syndrome (Independence Administrators)
Policy: 06.02.32d:Multigene Expression Assays for Predicting Recurrence in Colon Cancer (Independence Administrators)
Policy: 06.02.04d:Fetal Fibronectin Enzyme (fFN) Immunoassay
Policy: 06.02.14i:In Vitro Chemosensitivity and Chemoresistance Assays
Policy: 06.02.17g:Serodiagnosis of Inflammatory Bowel Disease (IBD) and the Prometheus® IBD sgi Diagnostic™ Test
Policy: 07.03.07t:Evaluation and Management of Autism Spectrum Disorder (ASD)
Policy: 12.01.01au:Experimental/Investigational Services