View Medical Policies

Showing 1– 20 of 294 Results
Title Last Updated Category
Wireless Capsule Endoscopy/Imaging for Examination of the Gastrointestinal (GI) Tract: AGILE Patency Capsule, Given® Capsule Camera, PillCam SB, PillCam ESO Open a PDF 6.01.27 2020-11-24 Digestive System (Gastroenterology)
Whole Exome and Whole Genome Sequencing for the Diagnosis of Genetic Disorders Open a PDF 2.02.46 2020-12-16 Genetic Disease (Inherited Disease)
Wheelchairs and Power Operated Vehicles Open a PDF 1.01.16 2021-07-20 Durable Medical Equipment & Supplies
Vitrectomy Chair/ Face-Down Positioning System Open a PDF 1.01.52 2021-05-21 Durable Medical Equipment & Supplies
Vision Therapy Open a PDF 9.01.04 2021-07-20 Eyes (Ophthalmology)
Ventricular Assist Devices (VAD, LVAD) Open a PDF 7.01.07 2020-09-03 Heart & Blood Vessels (Cardiovascular)
Varicosities/Varicose Veins, Treatment Alternatives to Vein Stripping and Ligation (e.g., Ambulatory, Stab or Transilluminated Powered Phlebectomy, ClariVein®, Endoluminal Radiofrequency Ablation, Endovenous Laser Ablation, Mechanochemical Endovenous Ablation, MOCA, Sclerotherapy, Varithena™, Venaseal™,VNUS) Open a PDF 7.01.47 2020-09-25 Cosmetic / Reconstructive Surgery
Vagus Nerve Stimulation and Vagus Nerve Blocking Therapy Open a PDF 7.01.05 2020-07-17 Nervous Systems (Neurology)
Urine Drug Testing, immunoassay, presumptive testing, confirmatory testing Open a PDF 2.02.50 2020-12-16 Lab Tests (pathology)
Urinary Tumor Markers for Bladder Cancer: AccuDx, BTA Stat™, Fibrin/Fibrinogen Degradation Products (FDP), ImmunoCyt, Nuclear Matrix Protein (NMP-22), Urinary Bladder Cancer Antigen (UBC Rapid Test) Open a PDF 2.02.12 2020-09-03 Lab Tests (pathology)
Tumor-Treatment Field Therapy for Glioblastoma: Electrical Field Therapy, NovoTTF-100™ Open a PDF 6.01.45 2021-04-19 Cancer Treatment (Oncology)
Treatment of Tinnitus: Habituation Therapy, Jastreboff Method, Masking, Retraining Therapy Open a PDF 8.01.07 2021-03-16 Ear, Nose & Throat (Otorhinolaryngology)
Treatment of Hirsutism/Hypertrichosis (Hair Removal) (e.g., Electrolysis, Epilation) Open a PDF 2.01.38 2021-01-07 Cosmetic / Reconstructive Surgery
Treatment of Gambling Disorder and Other Repetitive Behaviors Open a PDF 3.01.19 2021-03-22 Behavioral Health (Psychology)
Transurethral Microwave Thermotherapy (e.g., Prostatron, Targis, Urowave System, CoreTherm, Prolieve, TMx-2000, TUMT) Open a PDF 7.01.28 2021-01-19 Urinary System (Genitourinary)
Transpupillary Thermotherapy (TTT) Open a PDF 9.01.05 2020-09-25 Eyes (Ophthalmology)
Transendoscopic Therapies for Gastroesophageal Reflux Disease (GERD): ELF, EndoCinch, Endoluminal Fundoplication, Endoluminal Gastroplication, Enteryx, EsophyX, Gatekeeper, Plexiglas Microspheres, NDO Plicator System, Radiofrequency Esophageal Treatment, Stretta) Open a PDF 7.01.45 2021-04-19 Digestive System (Gastroenterology)
Transcranial Magnetic Stimulation Open a PDF 3.01.09 2021-07-13 Behavioral Health (Psychology)
Transcranial Doppler Ultrasound Open a PDF 6.01.18 2021-01-19 Radiology (x-rays) & Imaging
Transcatheter Closure Devices for Cardiac Defects: Amplatzer Septal Occluder, Angel Wing Device, Atrial Septal Detect Occluding System (ASDOS), CardioSEAL, HELEX, Sideris Buttoned Device Open a PDF 7.01.34 2020-09-03 Heart & Blood Vessels (Cardiovascular)
Showing 1– 20 of 294 Results
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