Medical Policy Crossword

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Across
  1. 1. Comprehensive genomic assay utilizing NGS technology to detect variants and often subject to clinical utility evidence
  2. 2. Weight loss surgical procedure needing comprehensive preoperative workup
  3. 6. Man Bun Hair Pig
  4. 8. Peer-reviewed literature, clinical trial data, and systematic reviews forming the foundation for coverage determination
Down
  1. 1. Prospective utilization management mechanism designed to ensure medical necessity compliance and cost-containment through clinical criteria validation before service delivery
  2. 3. Secondary review mechanism triggered when initial coverage determination conflicts with provider's clinical judgment, often requiring independent medical review or external review organization evaluation per state mandates
  3. 4. therapeutic apparatus requiring FDA classification and sustains long term use
  4. 5. Adverse determination resulting from failure to meet established medical necessity criteria
  5. 7. Reconstructive procedures for gender dysphoria treatment