ND Committee Review
Internal Medical Policy Committee 1-14-2019
Internal Medical Policy Committee 9-26-2019 Coding update,
- Updated
procedure code from C9038 to J9204
Internal Medical Policy Committee 7-22-2020
- Changed
procedure code J9204 to per-certification drug
Internal Medical Policy Committee 9-21-2020
- Updated
NCCN recommendations
Internal Medical Policy Committee 9-21-2021 Annual Review
Internal Medical Policy Committee 11-23-2021
- Corrected
Dx code error C85.16 changed to C84.16,
and
- Updated
formatting
Internal Medical Policy Committee 11-29-2022 Annual review, no clinical content change
Internal Medical Policy Committee 7-26-2023 -
Effective September 01, 2023
- Removed
NCCN Recommendations
- Added
Compendia sources statement 'Drug may be considered medically necessary for treatment of any of the current category 1 or 2A NCCN recommendations.'
- Updated
experimental/investigational statement
Internal Medical Policy Committee 7-16-2024
Effective September 01, 2024
- Annual review
no clinical content change
Internal Medical Policy Committee 11-19-2024
Effective December 08, 2024