Medical Policies - Medical

Apheresis Commercial - Medical 128

Apheresis Medicaid - Medical 128

Autologous Myoblast and Muscle Cell Injection Commercial - Medical 262

Autologous Myoblast and Muscle Cell Injection Medicaid - Medical 262

Automated Nerve Conduction Testing Commercial - Medical 250

Automated Nerve Conduction Testing Medicaid - Medical 250

Bone Scaffolding Commercial - Medical 02

Bone Scaffolding Medicaid - Medical 02

Category III codes Commercial - Medical 336

Category III codes Medicaid - Medical 336

Chemotherapy and Supportive Care Commercial Medical 316

Chemotherapy and Supportive Care Medicaid Medical 316

Chemotherapy and Supportive Care Medicare - Medical 316

Chiropractic Services Commercial - Medical 182

Dry Hydrotherapy Commercial - Medical 267

Dry Hydrotherapy Medicaid - Medical 267

Dry Needling Commercial - Medical 173

Dry Needling Medicaid - Medical 173

Electric Stimulation Commercial - Medical 349

Electric Stimulation Medicaid-Medical 349

Enteral and Parenteral Feeding and Intradialytic Parenteral Nutrition Commercial - Medical 13

Enteral and Parenteral Feeding and Intradialytic Parenteral Nutrition Medicaid - Medical 13

Eustachian tube balloon dilation (ETBD) Tuboplasty Commercial - Medical 328

Eustachian tube balloon dilation (ETBD) Tuboplasty Medicaid - Medical 328

Eustachian tube balloon dilation (ETBD) Tuboplasty Medicare - Medical 328

Fetal Magnetic Cardiac Signal Commercial - Medical 297

Fetal Magnetic Cardiac Signal Medicaid -Medical 297

Fetal Magnetic Cardiac Signal Medicare - Medical 297

Gait analysis and surface electromyography Commercial - Medical 345.pdf

Gait Analysis and Surface Electromyography Medicaid - Medical 345.pdf

Gait Analysis and Surface Electromyography Medicare - Medical 345.pdf

Gastrointestinal Capsule Endoscopy Commercial - Medical 81

Gastrointestinal Capsule Endoscopy Medicaid - Medical 81

Home Health Aide Commercial - Medical 144

Home Health Aide Medicaid - Medical 144

Immunoglobulin Light Chains Medicaid - Medical 333

Immunoglobulin Light Chains Medicare - Medical 333

Implantable Hemodynamic Monitoring for Heart Failure Commercial - Medical 317

Implantable Hemodynamic Monitoring for Heart Failure Medicaid - Medical 317

Ingestible Devices Commercial - Medical 344

Ingestible Devices Medicaid Medical 344.pdf

Ingestible Devices Medicare - Medical 344

Injectable Fillers & Bulking Agents Commercial - Medical 153

Injectable Fillers & Bulking Agents Medicaid - Medical 153

Intensive Cardiac Rehabilitation Programs Commercial - Medical 52

Intensive Cardiac Rehabilitation Programs Medicaid - Medical 52

Intra-arterial (IA) Chemotherapy Commercial - Medical 254

Intra-arterial (IA) Chemotherapy Medicaid - Medical 254

Keratoconus Lenses and Interventions-Piggyback Contact Lenses Commercial - Medical 03

Keratoconus Lenses and Interventions-Piggyback Contact Lenses Medicaid - Medical 03

Level of Care Guidance for Observation vs Inpatient Hospital Stays Commercial - Medical 350

Level of Care Guidance for Observation vs Inpatient Hospital Stays Medicaid - Medical 350

Long-Term Care Hospital (LTACH) Services Medicaid - Medical 337

Long-Term Care Hospital (LTACH) Services s Medicare Medical 337.pdf

Medical Necessity Guidelines Commercial - Medical 347

Mobile Cardiac Telemetry Commercial - Medical 112

Mobile Cardiac Telemetry Medicaid - Medical 112

Muscle Pain Detector Commercial - Medical 247

Muscle Pain Detector Medicaid - Medical 247

Nonemergent Ambulance Services Commercial - Medical 105

Nonemergent Ambulance Services Medicaid - Medical 105

Not Medically Necessary, Experimental, Investigational and Unproven Guidelines Commercial - Medical 348

Phase II Cardiac Rehabilitation Commercial - Medical 51

Phase II Cardiac Rehabilitation Medicaid - Medical 51

Physical Therapy for Treating Obesity Commercial - Medical 252

Physical Therapy for Treating Obesity Medicaid - Medical 252

Physical Therapy for Treating Obesity Medicare - Medical 252

Platelet Rich-Plasma Commercial - Medical 246

Platelet Rich-Plasma Medicaid - Medical 246

Prescription Digital Therapeutics and Devices Commercial Medical 259

Prescription Digital Therapeutics and Devices Medicaid Medical 259

Prescription Digital Therapeutics and Devices Medicare Medical 259

Radiation Therapy for Non-oncologic Indications Commercial Medical 351

Radiation Therapy for Non-oncologic Indications Medicaid Medical 351

Sepsis and Other Febrile Illness, Observation Care Medicaid Medical 346 OBS

Sepsis and Other Febrile Illness, Observation Care Medical 346 OBS

Sepsis and Other Febrile Illness, without Focal Infection Commercial Medical 346

Sepsis and Other Febrile Illness, without Focal Infection Medicaid Medical 346

Transarterial Embolization Direct Therapies (TAE, TACE and DEB-TACE) Commercial - Medical 139

Transarterial Embolization Direct Therapies (TAE, TACE and DEB-TACE) Medicaid - Medical 139

Transjugular Intrahepatic Portosystemic Shunt (TIPSS) Commercial - Medical 256

Transjugular Intrahepatic Portosystemic Shunt (TIPSS) Medicaid - Medical 256

Transjugular Intrahepatic Portosystemic Shunt (TIPSS) Medicare - Medical 256

Urinary Incontinence Treatments Commercial - Medical 130

Urinary Incontinence Treatments Medicaid - Medical 130

Vestibular Evoked Myogenic Potential (VEMP) Commercial - Medical 174

Vestibular Evoked Myogenic Potential (VEMP) Medicaid - Medical 174

Vision Therapy for Convergence Insufficiency Commercial - Medical 324

Vision Therapy for Convergence Insufficiency Medicaid - Medical 324

Vision Therapy for Convergence Insufficiency Medicare Medical 324

Wound Treatment Commercial - Medical 343

Wound Treatment Medicaid - Medical 343