https://www.premera.com/medicalpolicies/1.01.520.pdf#search=policy
POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ... This policy describes when a hospital bed may be covered for use at home. Note: The ...
https://www.premera.com/medicalpolicies/10.01.523.pdf#search=policy
below to be directed to that section. POLICY CRITERIA | CODING | RELATED INFORMATION ... section is for your general knowledge and is not to be taken as policy coverage criteria. ...
https://www.premera.com/medicalpolicies/15.01.015.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.015 Urine Culture Testing for Bacteria Ref. Policy: G2156 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/15.01.036.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.036 Diagnosis of Idiopathic Environmental Intolerance Ref. Policy: G2056 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: ...
https://www.premera.com/medicalpolicies/15.01.046.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.046 Prescription Medication and Illicit Drug Testing in the Outpatient Setting Ref. Policy: T2015 Effective Date: Feb. 6, 2026 Last Revised: ...
https://www.premera.com/medicalpolicies/5.01.631.pdf#search=policy
Policy: 2.01.92 Effective Date: Sep. 1, 2025 Last Revised: Oct. 1, 2025 Replaces: N/A RELATED MEDICAL POLICIES: N/A Select a hyperlink below to be directed to that section. POLICY ...
https://www.premera.com/medicalpolicies/10.01.517.pdf#search=policy
Policy and Clinical Guidelines: Definitions and Procedures 10.01.514 Cosmetic and Reconstructive Services Select a hyperlink below to be directed to that section. POLICY ...
https://www.premera.com/medicalpolicies/11.01.510_2026-01-02.pdf#search=policy
Stay, and Transition of Care Guideline Effective Date: Jan. 2, 2026* Last Revised: Sep. 9, 2025 Replaces: N/A *This policy has been revised. Click here to view the current policy. ...
https://www.premera.com/medicalpolicies/11.01.522.pdf#search=policy
POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ... This policy describes skilled hourly care and outlines how the plan may cover these ...
https://www.premera.com/medicalpolicies/15.01.016.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.016 Identification of Microorganisms using Nucleic Acid Probes Ref. Policy: M2097 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 ...
https://www.premera.com/medicalpolicies/15.01.023.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.023 Serum Testing for Evidence of Mild Traumatic Brain Injury Ref. Policy: G2151 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 ...
https://www.premera.com/medicalpolicies/15.01.030.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.030 Diagnostic Testing of Iron Homeostasis and Metabolism Ref. Policy: G2011 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 ...
https://www.premera.com/medicalpolicies/8.01.502.pdf#search=policy
Note: The Introduction section is for your general knowledge and is not to be taken as policy coverage criteria. The rest of the policy uses specific words and concepts familiar to ...
https://www.premera.com/medicalpolicies/9.02.503.pdf#search=policy
POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ... In some cases, other imaging such as MRI or ultrasound, are needed. This policy explains ...
https://www.premera.com/medicalpolicies/15.01.040.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.040 Biomarker Testing for Autoimmune Rheumatic Disease Ref. Policy: G2022 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: ...
https://www.premera.com/medicalpolicies/15.01.048.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.048 Testing for Alpha-1 Antitrypsin Deficiency Ref. Policy: M2068 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: N/A ...
https://www.premera.com/medicalpolicies/15.01.006.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.006 Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing Ref. Policy: G2164 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, ...
https://www.premera.com/medicalpolicies/15.01.021.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.021 Gamma-glutamyl Transferase Testing in Adults Ref. Policy: G2173 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: N/A ...
https://www.premera.com/medicalpolicies/15.01.029.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.029 Vitamin B12 and Methylmalonic Acid Testing Ref. Policy: G2014 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: N/A ...
https://www.premera.com/medicalpolicies/15.01.044.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.044 Therapeutic Drug Monitoring for 5-Fluorouracil Ref. Policy: M2067 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: N/A ...