| Required by Cigna policy CIGNA-RO-PBT-DEMO | Source in chart | Match | Status |
|---|---|---|---|
Histologic confirmation C-1 · §A.1 | EGD biopsy pathology Aug 12, 2026 · US Oncology Pathology · p. 1 | Exact | Included |
Staging workup C-2 · §A.2 | PET/CT and EUS Aug 25, 2026 · Baylor Radiology · p. 1 | Exact | Included |
ECOG 0–2 C-3 · §A.3 | Radiation oncology consult Sep 9, 2026 · R. Lee, MD · p. 1 | Exact | Included |
Esophagus: heart and lung dose for both plans C-4 · §B.2 | Comparative plan report — heart/lung Sep 23, 2026 · K. Bhatt, CMD · p. 1 | Exact | Included |
Comparative IMRT plan C-5 · §B.1 | Comparative plan report Sep 23, 2026 · K. Bhatt, CMD · p. 1 | Exact | Included |
Multidisciplinary recommendation C-6 · §A.4 | GI tumor board Sep 15, 2026 · GI Tumor Board · p. 1 | Exact | Included |
Re-irradiation: cumulative dose C-7 · §C.1 · Not on branch: requires prior RT to the treatment field | Not required on this branch | — | Not on branch |
Signed letter of medical necessity C-8 · §D.1 · signature required | Letter of medical necessity Sep 25, 2026 · R. Lee, MD · p. 1 | Exact | Included |
None yet. When the audit fails a criterion, ACE searches the chart again before asking a person.
Nothing is waiting on a person. Every applicable criterion is met or resolved.