View Medical Policies

Showing 1– 20 of 292 Results
Title Last Updated Category
Lumbar Decompression Open a PDF 7.01.97 2020-02-20 Bone & Joints (Orthopedic)
Low Level Laser Therapy (LLLT) Open a PDF 8.01.23 2020-02-24 Skin (Dermatology)
Transcranial Magnetic Stimulation: Deep TMS device, MagVita TMS, NeuroStar TMS device, rTMS, TMS Open a PDF 3.01.09 2020-02-24 Behavioral Health (Psychology)
Percutaneous Vertebroplasty, Kyphoplasty, Mechanical Vertebral Augmentation (e.g., Kyphon Inflatable Bone Tamp) Open a PDF 6.01.17 2020-02-24 Bone & Joints (Orthopedic)
Pathfinder TG® Molecular Testing: Redpath, Topographic Genotyping Open a PDF 2.02.39 2020-02-24 Lab Tests (pathology)
Pancreas Transplant (Pancreas Transplant Alone, Pancreas After Kidney Transplant, Simultaneous Pancreas Kidney Transplant) Open a PDF 7.02.01 2020-02-24 Transplants
Lumbar Fusion for Adults, Degenerative Disc Disease, Disc herniation, Lumbar arthrodesis, Scoliosis, Spinal stenosis, spondylodesis, spondylosyndesis, spondylolisthesis Open a PDF 7.01.90 2020-02-24 Bone & Joints (Orthopedic)
Low-Dose Computed Tomography (LDCT) for Lung Cancer Screening: Electron Beam Computed Tomography (EBCT), Helical CT, Low-Dose CT, Spiral CT Open a PDF 6.01.19 2020-02-24 Radiology (x-rays) & Imaging
Ketamine for the Treatment of Psychiatric Disorders Open a PDF 3.01.13 2020-02-24 Behavioral Health (Psychology)
Growth Factors for Wound Healing and Other Conditions: Becaplermin, Platelet Derived Growth Factor (PDGF), Platelet Rich Plasma, Regranex Open a PDF 2.01.24 2020-02-24 Skin (Dermatology)
Genotyping or Phenotyping for Thiopurine Methyltransferase (TPMT) for Patients Treated with Azathioprine (6-MP), Inflammatory Bowel Disease Open a PDF 2.02.37 2020-02-24 Genetic Disease (Inherited Disease)
Measurement of Exhaled Markers of Airway Inflammation in Patients with Asthma: Exhaled Breath Condensate, Exhaled Nitric Oxide, Nioxx Open a PDF 2.01.41 2020-02-24 Lungs (Respiratory)
Electromagnetic Navigation Bronchoscopy (ENB) Open a PDF 6.01.40 2020-02-24 Lungs (Respiratory)
Collagenase Clostridium Histolyticum (Xiaflex) for Fibroproliferative Disorders Open a PDF 5.01.15 2020-02-24 Drug / Medications
Computerized Motion Diagnostic Imaging (CMDI), Gait Analysis, Spinoscopy Open a PDF 2.01.13 2020-02-24 Bone & Joints (Orthopedic)
Artificial Lumbar Intervertebral Disc (e.g.,ActivL®,Bryan, Charité, ProDisc, ) Open a PDF 7.01.63 2020-02-24 Bone & Joints (Orthopedic)
Artificial Cervical Intervertebral Discs (e.g., Bryan, Mobi-C, PCM [Porous Coated Motion] Cervical Disc®, Prestige®, ProDisc®, Secure-C) Open a PDF 7.01.80 2020-02-24 Bone & Joints (Orthopedic)
Brachytherapy after Breast Conserving Surgery, as Boost with Whole Breast Irradiation or Alone as Accelerated Partial Breast Irradiation: Accelerated Partial Breast Irradiation, APBI, Axxent, MammoSite Open a PDF 6.01.30 2020-03-04 Radiation Treatment
Gastric Electrical Stimulation and Gastric Pacing Open a PDF 7.01.64 2020-03-06 Digestive System (Gastroenterology)
Gene Expression Analysis for Prostate Cancer Management: Oncotype DX® Prostate, Prolaris® Open a PDF 2.02.48 2020-03-10 Genetic Disease (Inherited Disease)
Showing 1– 20 of 292 Results