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.133 Digital EEG Spike Analysis (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.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.259 In Lieu of Services (PDF)
- WNC.CP.261 Wireless Capsule Endoscopy (PDF)
- WNC.CP.272 Hospice Services (PDF)
- WNC.CP.273 Blepharoplasty and Blepharoptosis (Eyelid Repair) (PDF)
- WNC.CP.114 Enhanced Mental Health and Substance Abuse Services (PDF)
- WNC.CP.285 Substance Abuse Intensive Outpatient Program SAIOP (PDF)
- WNC.CP.286 Substance Abuse Comprehensive Outpatient Treatment SACOT (PDF)
- WNC.CP.288 Clinically Managed Residential Withdrawal Management Services (ASAM 3.2 WM) (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.300 Casgevy Pharmacy Prior Approval Criteria (PDF)
- WNC.CP.301 Lyfgenia Pharmacy Prior Approval Criteria (PDF)
- WNC.CP.302 Zolgensma - Pharmacy Prior Approval Criteria (PDF)