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