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Amerigroup.com/medicalpolicies/guidelines/glpwa053761. htm. Clinical information Please include any relevant medical records to support the request for testing. Traumatic brain injury date Encephalitis date Epilepsy and cognitive Multiple sclerosis and impairment suspected suspected/demonstrated or documented date cognitive impairment date Anoxic/hypoxic brain injury date CVA date Psychosis date Major affective disorder History of intracranial surgery Brain tumor in Neurosurgery planned...
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