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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023

Reimbursement Policy: PO-RE-064 Immunopharmacologic Monitoring of Therapeutic Serum Antibodies

To manage loss of response due to the development of anti-drug antibodies, immunopharmacologic monitoring of circulating drug and anti-drug antibody levels has been proposed.

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023

Reimbursement Policy: PO-RE-035 Prostate Biopsy Specimen Analysis

Prostate cancer is characterized by a malignancy of the small walnut-shaped gland that produces seminal fluid. This malignancy can present with a wide clinical range, from only being a microscopic, well-differentiated tumor that may never be clinically significant all the way to being an aggressive, high-grade cancer (Taplin & Smith, 2023).

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023

Reimbursement Policy: PO-RE-049 Metabolite Markers of Thiopurines Testing

Thiopurines are a class of purine antimetabolite immunomodulators with diverse clinical applications in treatment of autoimmune disorders, transplant rejection, and acute lymphoblastic leukemia (Belmont, 2022).

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023

Reimbursement Policy: PO-RE-022 Cervical Cancer Screening

Cervical cancer screening detects cervical precancerous lesions and cancer through cytology, human papillomavirus (HPV) testing, and if needed, colposcopy (Feldman et al., 2023).

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023

Reimbursement Policy: PO-RE-058 Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a class of inflammatory bowel disorders comprised of two major disorders: ulcerative colitis and Crohn’s disease each with distinct pathologic and clinical characteristics (Peppercorn & Cheifetz, 2023).

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023

Reimbursement Policy: PO-RE-009 Diagnostic Testing of Influenza

Influenza is an acute respiratory illness caused by influenza A or B viruses resulting in upper and lower respiratory tract infection, fever, malaise, headache, and weakness.

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023

Reimbursement Policy: PO-RE-016 β-Hemolytic Streptococcus Testing

Streptococcus are Gram-positive, catalase-negative bacteria that are further divided into α-hemolytic, such as S. pneumoniae and S. mutans; β-hemolytic, such as S. pyogenes (Group A), S. agalactiae (Group B), and S. dysgalactiae subsp equisimilis (Groups C and G); and γ-hemolytic, such as Enterococcus faecalis and E. faecium (Wessels, 2022).

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023

Reimbursement Policy: PO-RE-043 Biochemical Markers of Alzheimer Disease and Dementia

Alzheimer disease (AD) is a neurodegenerative disease defined by a gradual decline in memory, cognitive functions, gross atrophy of the brain, and accumulation of extracellular amyloid plaques and intracellular neurofibrillary tangles (Karch et al., 2014).

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023

Reimbursement Policy: PO-RE-046 Nerve Fiber Density Testing

Nerve fiber density testing involves analysis of skin biopsy stained with an antibody to anti protein gene product 9.5 (Wilkinson et al., 1989) which avidly stains all axons (Dalsgaard et al., 1989).

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023

Reimbursement Policy: PO-RE-051 Celiac Disease Testing

Celiac disease is a hereditary, chronic autoimmune disorder triggered by the ingestion of gluten, a protein found in wheat, rye, and barley.

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023

Reimbursement Policy: PO-RE-053 Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing

Intestinal dysbiosis is defined as a disruption or imbalance of the intestinal microbial ecology (Guinane & Cotter, 2013).

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023

Reimbursement Policy: PO-RE-054 Fecal Calprotectin Testing in Adults

Calprotectin is a small calcium-binding protein found in high concentration in the cytosol of neutrophils (Fagerhol et al., 1980) and to a lesser extent monocytes and macrophages (Hsu et al., 2009).

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Reimbursement Policy: PO-RE-064 Immunopharmacologic Monitoring of Therapeutic Serum Antibodies

Reimbursement Policy: PO-RE-035 Prostate Biopsy Specimen Analysis

Reimbursement Policy: PO-RE-049 Metabolite Markers of Thiopurines Testing

Reimbursement Policy: PO-RE-022 Cervical Cancer Screening

Reimbursement Policy: PO-RE-058 Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease

Reimbursement Policy: PO-RE-009 Diagnostic Testing of Influenza

Reimbursement Policy: PO-RE-016 β-Hemolytic Streptococcus Testing

Reimbursement Policy: PO-RE-043 Biochemical Markers of Alzheimer Disease and Dementia

Reimbursement Policy: PO-RE-046 Nerve Fiber Density Testing

Reimbursement Policy: PO-RE-051 Celiac Disease Testing

Reimbursement Policy: PO-RE-053 Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing

Reimbursement Policy: PO-RE-054 Fecal Calprotectin Testing in Adults

Resource Type

Filter

Year

Sort By

Reimbursement Policy: PO-RE-064 Immunopharmacologic Monitoring of Therapeutic Serum Antibodies

Reimbursement Policy: PO-RE-035 Prostate Biopsy Specimen Analysis

Reimbursement Policy: PO-RE-049 Metabolite Markers of Thiopurines Testing

Reimbursement Policy: PO-RE-022 Cervical Cancer Screening

Reimbursement Policy: PO-RE-058 Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease

Reimbursement Policy: PO-RE-009 Diagnostic Testing of Influenza

Reimbursement Policy: PO-RE-016 β-Hemolytic Streptococcus Testing

Reimbursement Policy: PO-RE-043 Biochemical Markers of Alzheimer Disease and Dementia

Reimbursement Policy: PO-RE-046 Nerve Fiber Density Testing

Reimbursement Policy: PO-RE-051 Celiac Disease Testing

Reimbursement Policy: PO-RE-053 Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing

Reimbursement Policy: PO-RE-054 Fecal Calprotectin Testing in Adults

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