Historical Medical Policies and Clinical Utilization Management Guidelines
Historical Medical Policies
Medical Policies contained within this page are historical and not the most current versions. Current Medical Policy content may be accessed from the Medical Policies & Clinical UM Guidelines page . Implementation dates of the most current versions vary per state notification requirements.
- LAB.00039 Pooled Antibiotic Sensitivity Testing
- SURG.00011 Allogeneic, Xenographic, Synthetic, Bioengineered, and Composite Products for Wound Healing and Soft Tissue Grafting
- SURG.00036 Fetal Surgery for Prenatally Diagnosed Malformations
- SURG.00052 Percutaneous Vertebral Disc and Vertebral Endplate Procedures
Historical Clinical UM Guidelines
Clinical UM Guidelines contained within this page are historical and not the most current versions. Current Clinical UM Guideline content may be accessed from the Medical Policies & Clinical UM Guidelines page . Implementation dates of the most current versions vary per state notification requirements.