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.
Policy Updates
- WNC.CP.103 Physician Fluoride Varnish Services (PDF)
- WNC.CP.114 Enhanced Mental Health and Substance Abuse Services (PDF)
- WNC.CP.129 Electric Tumor Treating Fields (PDF)
- WNC.CP.131 Phototherapy for Neonatal Hyperbilirubinemia (PDF)
- WNC.CP.190 Keloid Excision and Scar Revision (PDF)
- WNC.CP.194 Fecal Microbiota Transplantation (PDF)
- WNC.CP.196 Out-of-State Services (PDF)
- WNC.CP.197 Surgery of the Lingual Frenulum (PDF)
- WNC.CP.198 Invasive Electrical Bone Growth Stimulation (PDF)
- WNC.CP.199 Hyperbaric Oxygenation Therapy (PDF)
- WNC.CP.205 Stereotactic Pallidotomy (PDF)
- WNC.CP.215 Nursing Equipment and Supplies (PDF)
- WNC.CP.220 Allergy Testing (PDF)
- WNC.CP.227 Surgery for Ambiguous Genitalia (PDF)
- WNC.CP.230 Vagus Nerve Stimulation for the Treatment of Seizures (PDF)
- WNC.CP.236 Reconstructive and Cosmetic Surgery (PDF)
- WNC.CP.237 Craniofacial Surgery (PDF)
- WNC.CP.261 Wireless Capsule Endoscopy (PDF)
- WNC.CP.262 Non-Emergency Medical Transportation (PDF)
- WNC.CP.272 Hospice Services (PDF)
- WNC.CP.273 Blepharoplasty Blepharoptosis (Eyelid Repair) (PDF)
- WNC.CP.275 Chiropractic Services (PDF)
- WNC.CP.277 Opioid Treatment Program Service (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 On-Site Monitoring (ASAM 2 WM) (PDF)
- WNC.CP.293 Genetic Testing for Diagnosis and Treatment (PDF)
- WNC.CP.294 Genetic Testing for Carrier and Prenatal (PDF)
- WNC.CP.295 Genetic Testing - Gene Expression (PDF)
- WNC.CP.296 Genetic Testing - Next Generation Sequencing (PDF)
- WNC.CP.297 Physical Health Clinical Policy Committee (PDF)
- WNC.CP.299 Cell and Gene Therapies (PDF)
- WNC.CP.106 Hearing Aid Services in Members Under Age 21 (PDF)
- WNC.CP.107 Routine Eye Examinations Visual Aids for Beneficiaries Under 21 years of Age (PDF)
- WNC.CP.117 Outpatient Behavioral Health Services Provided by Direct-Enrolled Providers (PDF)
- WNC.CP.135 Homocysteine Testing (PDF)
- WNC.CP.189 Rhinoplasty and or Septoplasty (PDF)
- WNC.CP.235 Balloon OstialDilation (PDF)
- WNC.CP.202 Heart (Cardiac) Transplantation (PDF)
- WNC.CP.203 Kidney (Renal) Transplantation (PDF)
- WNC.CP.204 Liver Transplantation (PDF)
- WNC.CP.246 Small Bowel and Small Bowel_Liver and Multivisceral Transplants (PDF)
- WNC.CP.247 Pancreas Transplant (PDF)
- WNC.CP.248 Islet Cell Transplantation (PDF)
- WNC.CP.249 Lung Transplantation (PDF)
- WNC.CP.250 Heart_Lung Transplantation (PDF)
- WNC.CP.152 Polymerase Chain Reaction Respiratory Viral Panel Testing (PDF)
- WNC.CP.162 Hyperhidrosis Treatments (PDF)
- WNC.CP.163 NICU Discharge Guidelines (PDF)
- WNC.CP.164 NICU Apnea Bradycardia Discharge Guidelines (PDF)
- WNC.CP.167 Neonatal Sepsis Management (PDF)
- WNC.CP.168 Neonatal Abstinence Syndrome Guidelines (PDF)
- WNC.CP.189 Rhinoplasty and or Septoplasty (PDF)
- WNC.CP.222 Skin Substitutes (PDF)
- WNC.CP.257 Special Ophthalmological Services (PDF)