ND Committee Review
Internal Medical Policy Committee 11-14-2019 Code update
Internal Medical Policy Committee 7-22-2020 -
Effective August 01, 2020
- Changed to pre-certification drug
- No clinical content change
Internal Medical Policy Committee 9-21-2020
- Updated
NCCN recommendations
Internal Medical Policy Committee 9-21-2021 Annual Review-no change in criteria
Internal Medical Policy Committee 5-24-2022
- Removed
NCCN recommendations and
- Added
this statement 'Copanlisib (Aliqopa) may be considered medically necessary for treatment of any of the current category 1 or 2A NCCN recommendations.',
- Updated
the experimental/investigational statement,
- Updated
dx codes
Internal Medical Policy Committee 5-23-2023 Annual review, no clinical content change
Internal Medical Policy Committee 5-14-2024
Effective July 01, 2024
- Annual review
no clinical content change