Medical policy updates
Below are links to updated or new policies. Remember, you can always find the latest updates to policies in the Pending/retired/updated medical policy list.
Effective May 14, 2020
Added family history as additional risk criteria when considering prophylactic simple mastectomy. This information was obtained from Comprehensive Cancer Network (NCCN) Guidelines for Genetic/Familial High-Risk Assessment: Breast and Ovarian.
Prior authorization is no longer required for the following procedures:
- Prophylactic gastrectomy
- Prophylactic hysterectomy
- Prophylactic mastectomy
- Prophylactic oophorectomy
- Prophylactic salpingo-oophorectomy
Prior authorization is still required for prophylactic thyroidectomy.