Clinical Coverage/Medical Policy Updates
WellCare of North Carolina updates a select number of clinical coverage policies each month, ensuring the reviewal of all policies on an annual basis.
Authorization Rule Updates
- WNC.CP.119 Cochlear and Auditory Brainstem Implant External Parts Replacement and Repair (PDF)
- WNC.CP.130 Sclerotherapy and Chemical Endovenous Ablation for Varicose Veins and Other Symptomatic Venous Disorders (PDF)
- WNC.CP.158 Experimental Technologies (PDF)
- WNC.CP.187 Ambulance Services (PDF)
- WNC.CP.193 Telehealth Virtual Communications and Remote Patient Monitoring (PDF)
- WNC.CP.196 Out-of-State Services (PDF)
- WNC.CP.207 Home Health Services (PDF)
- WNC.CP.212 Diagnostic Assessment (PDF)
- WNC.CP.226 Sterilization Procedures (PDF)
- WNC.CP.231 Peer Support Services (PDF)
- WNC.CP.252 Acute Inpatient Hospital Services (PDF)
- WNC.CP.276 Hearing Aid Services in Adult Members Aged 21 and older (PDF)
- WNC.CP.104 Breast Surgeries (PDF)
- WNC.CP.109 Research Based Behavioral Health Treatment (RB-BHT) for Autism Spectrum Disorder (ASD) (PDF)
- WNC.CP.120 Endometrial Ablation (PDF)
- WNC.CP.174 Urodynamic Testing (PDF)
- WNC.CP.176 Bronchial Thermoplasty (PDF)
- WNC.CP.178 Implantable Wireless Pulmonary Artery Pressure Monitoring (PDF)
- WNC.CP.222 Skin Substitutes (PDF)
- WNC.CP.256 Medically Necessary Circumcision (PDF)
- WNC.CP.261 Wireless Capsule Endoscopy (PDF)
- WNC.CP.263 Child First Services (PDF)
- WNC.CP.269 Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing (PDF)
- WNC.CP.271 Therapeutic and Non-Therapeutic Abortions (PDF)
- Adopted Clinical Practice Guidelines: CPG Grid (PDF)
- WNC.CP.105 Private Duty Nursing for Beneficiaries Age 21 and Older (PDF)
- WNC.CP.114 Enhanced Mental Health and Substance Abuse Services (PDF)
- WNC.CP.116 Facility-Based Crisis Service for Children and Adolescents (PDF)
- WNC.CP.173 Testing for Select Genitourinary Conditions (PDF)
- WNC.CP.208 Private Duty Nursing for Beneficiaries Under 21 years of Age (PDF)
- WNC.CP.212 Diagnostic Assessment (PDF)
- WNC.CP.220 Allergy Testing (PDF)
- WNC.CP.221 Allergy Immunotherapy (PDF)
- WNC.CP.224 Home Infusion Therapy (PDF)
- WNC.CP.228 Surgery for Clinically Severe or Morbid Obesity (PDF)
- WNC.CP.229 Evoked Potential Testing (PDF)
- WNC.CP.234 Nursing Facility Services (PDF)
- WNC.CP.253 Drug Testing for Opioid Treatment and Controlled Substance Monitoring (PDF)
- WNC.CP.259 In Lieu of Services (PDF)
- WNC.CP.265 Caudal or Interlaminar Epidural Steroid Injections_Trial of Implantable Intrathecal Pain Pump (PDF)
- WNC.CP.277 Opioid Treatment Program Service (PDF)
- WNC.CP.279 Thymus Tissue Implantation (PDF)
- WNC.CP.281 Medically Monitored Inpatient Withdrawal Services (ASAM 3.7 WM) (PDF)
- WNC.CP.289 Ambulatory Withdrawal Management Without Extended Onsite Monitoring (ASAM 1 WM) (PDF)
- WNC.CP.290 Ambulatory Withdrawal Management With Extended Onsite Monitoring (ASAM 2 WM) (PDF)