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.101 Physicians Drug Program (PDF)
- WNC.CP.126 Urinary Incontinence Devices and Treatments (PDF)
- WNC.CP.142 Helicobacter Pylori Serology Testing (PDF)
- WNC.CP.180 Extended Ophthalmoscopy (PDF)
- WNC.CP.214 Hysterectomy (PDF)
- WNC.CP.216 Orthotics Prosthetics (PDF)
- WNC.CP.217 Extracorporeal Shock Wave Lithotripsy (PDF)
- WNC.CP.102 Family Planning Service (PDF)
- WNC.CP.104 Breast Surgeries (PDF)
- WNC.CP.105 Private Duty Nursing for Beneficiaries Age 21 and Older (PDF)
- WNC.CP.107 Routine Eye Examinations Visual Aids for Beneficiaries Under 21 years of Age (PDF)
- WNC.CP.108 Physical Rehabilitation Equipment and Supplies (PDF)
- WNC.CP.111 Implantable Bone Conduction Hearing Aids (BAHA) (PDF)
- WNC.CP.112 Cochlear and Auditory Brainstem Implants (PDF)
- WNC.CP.113 Soft Band & Implantable Bone Conduction Hearing Aid External Parts Replacement & Repair (PDF)
- WNC.CP.121 Optic Nerve Decompression Surgery (PDF)
- WNC.CP.181 Fluorescein Angiography (PDF)
- WNC.CP.183 Gonioscopy (PDF)
- WNC.CP.184 External Ocular Photography (PDF)
- WNC.CP.185 Visual Field Testing (PDF)
- WNC.CP.186 Teleretinal Screening for Diabetic Retinopathy (PDF)
- WNC.CP.188 Maternal Care Skilled Nurse Home Visit (PDF)
- WNC.CP.191 Placental and Umbilical Cord Blood as a Source of Stem Cells (PDF)
- WNC.CP.192 CAR-T Cell Therapy (PDF)
- WNC.CP.208 Private Duty Nursing for Beneficiaries Under 21 years of Age (PDF)
- WNC.CP.210 Dietary Evaluation and Counseling and Medical Lactation Services (PDF)
- WNC.CP.211 Geropsychiatric Units in Nursing Facilitiess (PDF)
- WNC.CP.213 Respiratory Equipment and Supplies (PDF)
- WNC.CP.215 Nursing Equipment and Supplies (PDF)
- WNC.CP.220 Allergy Testing (PDF)
- WNC.CP.221 Allergy Immunotherapy (PDF)
- WNC.CP.223 Phase II Outpatient Cardiac Rehabilitation Programs (PDF)
- WNC.CP.225 Fetal Surveillance (PDF)
- WNC.CP.230 Vagus Nerve Stimulation for the Treatment of Seizures (PDF)
- WNC.CP.251 Long Term Care Hospital Services (PDF)
- WNC.CP.252 Acute Inpatient Hospital Services (PDF)
- WNC.CP.258 Inpatient Behavioral Health Services (PDF)
- WNC.CP.264 Discography (PDF)
- WNC.CP.265 Caudal or Interlaminar Epidural Steroid Injections_Trial of Implantable Intrathecal Pain Pump (PDF)
- WNC.CP.267 Facet Joint Interventions (PDF)
- WNC.CP.275 Chiropractic Services (PDF)
- WNC.CP.282 Medically Necessary Routine Foot Care (PDF)
- WNC.CP.283 General Ophthalmological Services (PDF)
- WNC.CP.284 Sleep Studies and Polysomnography Services (PDF)
- WNC.CP.293 Genetic Testing - Diagnosis and Treatment (PDF)
- WNC.CP.294 Genetic Testing - Carrier and Prenatal (PDF)
- WNC.CP.295 Genetic Testing - Gene Expression (PDF)
- WNC.CP.296 Genetic Testing - Next Generation Sequencing (PDF)
- WNC.CP.297 Clinical Policy Committee (PDF)
- WNC.CP.115 Routine Patient Costs Furnished in Connection with Participation in Qualifying Clinical Trials (PDF)
- WNC.CP.232 Ventricular Assist Devices (PDF)
- WNC.CP.238 Hematopoietic Stem-Cell Transplantation for Leukemia (PDF)
- WNC.CP.239 Hematopoietic Stem-CellTransplantation for Lymphoma (PDF)
- WNC.CP.240 Hematopoietic Stem-Cell Transplantation for Solid Tumors of Childhood (PDF)
- WNC.CP.241 Allogeneic Hematopoietic Stem Cell Transplantation for Genetic Diseases and Acquired Anemias (PDF)
- WNC.CP.242 Hematopoietic Stem-Cell Transplantation in the Treatment of Germ Cell Tumors (PDF)
- WNC.CP.243 Hematopoietic Stem-Cell Transplantation For Multiple Myeloma, POEMS Syndrome and Primary Amyloidosis (PDF)
- WNC.CP.244 Allogeneic Hematopoietic Stem-Cell Transplantation for Myelodysplastic Syndromes Myeloproliferative Neoplasms (PDF)
- WNC.CP.245 Hematopoietic Stem-Cell Transplantation for Central Nervous System (CNS) Embryonal Tumors Ependymoma (PDF)
- WNC.CP.273 Blepharoplasty Blepharoptosis (Eyelid Repair) (PDF)
- WNC.CP.277 Opioid Treatment Program Service (PDF)