Clinical Criteria for Prior Authorizations
Enhanced Respiratory Care (ERC)
Pharmacy Clinical Guidelines
- Cook County Healthcare and Hospitals Systems Prior Authorization Guidelines
- New Century Health Drug Policies
Clinical Policies and Procedures
- PA.079.CC – Experimental and Investigational
- PA.253.CC – Utilization Review Process
- eviCore PA List Effective 11.01.23
- PA.040.CC Bariatric Surgery
- PA.252.CC – Determination of Medical Necessity
- PA.237.CC – Human Donor Milk
- PA.007.CC – Transplant: Lung and Lobar Lung
- PA.251.CC – Fertility Preservation for Iatrogenic Infertility
- PA.078 – Clinical Trials Policy & Procedure Manual
- PA.018 – Gene Expression Testing for Breast Cancer Policy
- See Diagnosis and Procedure Codes for Elective Delivery
- PA.248.CC Site of Service Policy
- PA.227.CC Authorization for Observation vs. Inpatient Admission Level of Care
- MP.079.CC Cosmetic and Reconstructive Procedures
- Surgical Management of Gender Dysphoria
- PA.243.CC Outpatient Major Joint Arthroplasty (Hips and Knees)
- Clinical Policy and Procedure: Car-T Therapy
- PA.249.CC Noninvasive Genetic Testing During Pregnancy PA.259.CC Genetic Testing
- PA.259.CC Genetic Testing
- Post-Acute Level of Care (PAC)
- Nutritional Support Medical Policy
- Cognitive Performance Testing
- Community Support Services
- Definitive (Quantitative) Urine Drug Testing
- Neurobehavioral Status Exam
- Psychosocial Rehabilitation
- Targeted Case Management
