ND Committee Review
Internal Medical Policy Committee 1-22-2020 New policy
Internal Medical Policy Committee 11-19-2020
- Added
additional NCCN recommendations to soft tissue sarcoma;
and
- Removed
diagnosis code Z80.49;
and
- Added
diagnosis code C22.3
Internal Medical Policy Committee 11-23-2021 Annual review, no clinical content change
Internal Medical Policy Committee 3-23-2022
- Removed
NCCN recommendations;
and
- Added
this statement 'Eribulin mesylate (Halaven) may be considered medically necessary for treatment of any of the current category 1 or 2A NCCN recommendations.';
and
- Updated
experimental/investigational statement;
and
- Removed
diagnosis codes C53.0, C78.00, C78.01, C78.02, Z85.3 and Z85.831
Internal Medical Policy Committee 3-23-2023 Annual Review, no clinical content change
Internal Medical Policy Committee 5-23-2023 -
Effective July 1, 2023
- Removed
diagnosis code C22.3
- Updated
E/I statement
