Medical Policy Updates

Notification of Policy Revisions Effective July 13, 2021 (Posted May 18, 2021)

Medical Policy Revision
Venous and Arterial Thrombosis Risk Testing AHS – M2041 "Notification" Reviewed by Avalon 1st Quarter 2021 CAB. Specified “deep” venous thrombosis throughout policy for clarity. The following changes made to the When Covered section: Item 1 – added item i.- ” Pediatric arterial ischemic stroke”; item 2 – added statement “Assays for clotting inhibitors amount and function should be performed prior to any molecular testing.” And item k. “Pediatric arterial ischemic stroke”. The following changes were made to the When Not Covered section: Item 2 – added statement “Reimbursement is not allowed for venous thrombosis risk testing for superficial venous thrombosis (including superficial thrombophlebitis and varicosities).”; to item 3 – added h. “Testing more than once per lifetime”. Policy guidelines and references updated. Policy noticed 5/18/21; effective 7/13/21. Medical Director review 4/2021.