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Clinical Policy Updates
Ambetter of Tennessee continuously updates select clinical policies each month. This page reflects upcoming clinical policy changes. Please refer to this page for recent policy updates and reach out to your Provider Relations representative if you have any questions.
- CG Testing: Pharmacogenetics (Version B) (V.2025.1) (PDF)
- Concert Genetic Testing: Aortopathies and Connective Tissue Disorders (V.2025.1) (PDF)
- Concert Genetic Testing: Cardiac Disorders (V.2025.1) (PDF)
- Concert Genetic Testing: Dermatologic Conditions (V.2025.1) (PDF)
- Concert Genetic Testing: Epilepsy, Neurodegenerative, and Neuromuscular Conditions V.2025.1) (PDF)
- Concert Genetic Testing: Exome and Genome Sequencing for the Diagnosis of Genetic Disorders (V.2025.1) (PDF)
- Concert Genetic Testing: Eye Disorders (V.2025.1) (PDF)
- Concert Genetic Testing: Gastroenterologic Disorders (non-cancerous) (V.2025.1) (PDF)
- Concert Genetic Testing: General Approach to Genetic and Molecular Testing (V.2025.1) (PDF)
- Concert Genetic Testing: Hearing Loss (V.2025.1) (PDF)
- Concert Genetic Testing: Hematologic Conditions (non-cancerous) (V.2025.1) (PDF)
- Concert Genetic Testing: Hereditary Cancer Susceptibility (V.2025.1) (PDF)
- Concert Genetic Testing: Immune, Autoimmune, and Rheumatoid Disorders (V.2025.1) (PDF)
- Concert Genetic Testing: Kidney Disorders (V.2025.1) (PDF)
- Concert Genetic Testing: Lung Disorders (V.2025.1) (PDF)
- Concert Genetic Testing: Metabolic, Endocrine, and Mitochondrial Disorders (V.2025.1) (PDF)
- Concert Genetic Testing: Multisystem Inherited Disorders, Intellectual Disability, and Developmental Delay (V.2025.1) (PDF)
- Concert Genetic Testing: Preimplantation Genetic Testing (V.2025.1) (PDF)
- Concert Genetic Testing: Prenatal and Preconception Carrier Screening (V.2025.1) (PDF)
- Concert Genetic Testing: Prenatal Diagnosis (via Amniocentesis, CVS, or PUBS) and Pregnancy Loss (V.2025.1) (PDF)
- Concert Genetic Testing: Skeletal Dysplasia and Rare Bone Disorders (V.2025.1) (PDF)
- Concert Genetics Oncology: Algorithmic Testing (V.2025.1) (PDF)
- Concert Genetics Oncology: Cancer Screening (V.2025.1) (PDF)
- Concert Genetics Oncology: Circulating Tumor DNA and Circulating Tumor Cells (Liquid Biopsy) (V.2025.1) (PDF)
- Concert Genetics Oncology: Cytogenetic Testing (V.2025.1) (PDF)
- Concert Genetics Oncology: Molecular Analysis of Solid Tumors and Hematologic Malignancies (V.2025.1) (PDF)
- Electric Tumor Treating Fields (CP.MP.145) (PDF)
- Facility Based Sleep Studies for Obstructive Sleep Apnea (CP.MP.248) (PDF)
- Implantable Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea (CP.MP.180) (PDF)
- Mechanical Stretch Devices for Joint Stiffness and Contracture (CP.MP.144) (PDF)
- Short Inpatient Hospital Stay (CP.MP.182) (PDF)
- Stereotactic Body Radiation Therapy (CP.MP.22) (PDF)
- Transplant Service Documentation Requirements (CP.MP.247) (PDF)
- Vagus Nerve Stimulation (CP.MP.12) (PDF)
- Applied Behavior Analysis (CP.BH.104) (PDF)
- Applied Behavioral Analysis Documentation Requirements (CP.BH.105) (PDF)
- Behavioral Health Treatment Documentation Requirements (HIM.CP.BH.500) (PDF)
- Deep Transcranial Magnetic Stimulation for Treatment of Obsessive Compulsive Disorder (CP.BH.201) (PDF)
- DME (CP.MP.107) (PDF)
- Gastric Electrical Stimulation (CP.MP.40) (PDF)
- Heart-Lung Transplant (CP.MP.132) (PDF)
- Hyperhidrosis Treatments (CP.MP.62) (PDF)
- Implantable Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea (CP.MP.180) (PDF)
- Intensity-Modulated Radiotherapy (CP.MP.69) (PDF)
- Long Term Care Placement (CP.MP.71) (PDF)
- Lung Transplantation (CP.MP.57) (PDF)
- NICU Apnea Bradycardia Guidelines (CP.MP.82) (PDF)
- NICU Discharge Guidelines (CP.MP.81) (PDF)
- Outpatient Cardiac Rehabilitation (CP.MP.176) (PDF)
- Pancreas Transplantation (CP.MP.102) (PDF)
- Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention (CP.MP.147) (PDF)
- Skin and Soft Tissue Substitutes for Chronic Wounds With changes (CP.MP.185) (PDF)
- Tandem Transplant (CP.MP.162) (PDF)
- Total Parenteral Nutrition and Intradialytic Parenteral Nutrition (CP.MP.163) (PDF)
- Transcranial Magnetic Stimulation for Treatment of Major Depression (CP.BH.200) (PDF)
- Transplant Service Documentation Requirements (CP.MP.247) (PDF)
- Urinary Incontinence Devices and Treatments (CP.MP.142) (PDF)