The Regence Group and its affiliated Plans use medical policies as guidelines for coverage decisions within the member’s written benefits. Below are summaries of recent changes to The Regence Group’s medical policies. The detailed policies and complete Medical Policy Manual are available online at www.regence.com/About/TRG Medical Policy Manual/. We have included the section and policy number for your convenience.

Note: We'd like to hear from you as we develop our medical policies.  If you would like to provide feedback on policies in draft form, you are welcome to join our e-mail reviewer list.  Visit us at https://www.regence.com/trg/contact/ to complete our online request form.

Added AlloMap as a new investigational test for heart transplant rejection.  There are no published studies investigating the clinical utility of the test and how it impacts the need for endomyocardial biopsy.

Effective: June 6, 2005

Clarified criteria: testing of MLH1, MSH2 and MSH6 for HNPCC carrier status is medically necessary when criteria met.  MSH6 testing should be done only after MLH1 and MSH2 tests are determined to be negative.

Effective: June 6, 2005

New investigational indications are added to the policy.  Hyperbaric oxygen therapy is considered investigational for the treatment of migraine headache, tinnitus, demyelinating disease such as amyotrophic lateral sclerosis and multiple sclerosis, and chronic cerebrovascular conditions such as subcortical frontal syndrome.

Effective: June 6, 2005

New policy with criteria for CF genetic testing based on NIH, ACOG/ACMG guidelines.  Testing may be considered medically necessary in  adults with a positive family history of CF, reproductive partners of individuals with CF, all couples currently planning a pregnancy or seeking prenatal testing.  Testing of the general population or routine newborn screening is considered not medically necessary.

Effective: June 6, 2005