Legal Disclaimer: Each physician, medical group, health plan, review organization or others using this manual must make an independent determination that these policies/guidelines apply, in entirety or in part, to any particular clinical or benefit determination or other circumstance under review.  more... Guidelines, by definition, are limited in scope and depth. These representative guidelines, policies and benefit interpretations are not intended to be construed or to serve as a certification and/or contractual agreement for payment or as a standard of medical care. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern. Policy are just examples and are intended for illustrative purposes only. It is not intended to be a recommendation of one product over another, and is not intended to represent a complete listing of all products available.  less Preface & Disclaimer