ND Committee Review
Internal Medical Policy Committee 3-16-2020
Adopted
policy
Internal Medical Policy Committee 3-17-2021 Annual review, no clinical content change
Internal Medical Policy Committee 9-21-2021
- Added
additional NCCN recommendations,
and
- Updated
diagnosis codes
Internal Medical Policy Committee 9-28-2022 Annual review, no clinical content change
Internal Medical Policy Committee 11-29-2022
- Removed
NCCN recommendations;
and
- Added
this statement 'Blinatumomab (Blincyto) may be considered medically necessary for treatment of any of the current category 1 or 2A NCCN recommendations.';
and
- Updated
experimental/investigational statement
Internal Medical Policy Committee 11-15-2023 Annual review, no clinical content change
Internal Medical Policy Committee 11-19-2024
Effective December 08, 2024