View Medical Policies

Showing 1– 20 of 295 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 2019-08-15 Digestive System (Gastroenterology)
Whole Exome and Whole Genome Sequencing for the Diagnosis of Genetic Disorders Open a PDF 2.02.46 2019-08-15 Genetic Disease (Inherited Disease)
Wheelchairs and Power Operated Vehicles (POVs) (e.g., Scooters) Open a PDF 1.01.16 2020-07-17 Durable Medical Equipment & Supplies
Vitrectomy Chair/ Face-Down Positioning System Open a PDF 1.01.52 2020-05-13 Durable Medical Equipment & Supplies
Vision/Eye Therapy: Optometric Phototherapy, Occlusion Therapy, Orthoptics, Pleoptics Open a PDF 9.01.04 2020-02-21 Eyes (Ophthalmology)
Ventricular Assist Devices (VAD, LVAD) Open a PDF 7.01.07 2019-09-19 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 Embolization, Endovenous Laser Ablation, Mechanochemical Endovenous Ablation, MOCA, Sclerotherapy, Varithena™, VenaSeal™, VNUS) Open a PDF 7.01.47 2019-10-15 Cosmetic / Reconstructive Surgery
Vagus Nerve Stimulation and Vagus Nerve Blocking Therapy Open a PDF 7.01.05 2020-07-17 Nervous Systems (Neurology)
Uterine Artery Occlusion in the Treatment of Uterine Fibroids: Uterine Artery/Fibroid Embolization (UAE/UFE), Uterine Artery Coagulation Open a PDF 4.01.04 2020-01-16 Women's Health (Obstetrics & Gynecology)
Urine Drug Testing, immunoassay, presumptive testing, confirmatory testing Open a PDF 2.02.50 2020-01-16 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 2019-08-22 Lab Tests (pathology)
Tumor-Treatment Field Therapy for Glioblastoma: Electrical Field Therapy, NovoTTF-100™ PDF Open a PDF 6.01.45 2020-04-15 Cancer Treatment (Oncology)
Treatment of Tinnitus: Habituation Therapy, Jastreboff Method, Masking, Retraining Therapy Open a PDF 8.01.07 2020-03-18 Ear, Nose & Throat (Otorhinolaryngology)
Treatment of Hirsutism/ Hypertrichosis (Hair Removal) (e.g., Electrolysis, Epilation) Open a PDF 2.01.38 2020-02-21 Cosmetic / Reconstructive Surgery
Treatment of Gambling Disorder and Other Repetitive Behaviors Open a PDF 3.01.19 2020-07-17 Behavioral Health (Psychology)
Transurethral Microwave Thermotherapy (TUMT) of the Prostate (e.g., Prostatron, Targis, Urowave System, CoreTherm, Prolieve, TMx-2000) Open a PDF 7.01.28 2020-01-22 Urinary System (Genitourinary)
Transpupillary Thermotherapy (TTT) Open a PDF 9.01.05 2019-09-19 Eyes (Ophthalmology)
Transendoscopic Therapies for Gastroesophageal Reflux Disease (GERD): ELF, EndoCinch, Endoluminal Funcoplication, Endoluminal Gastroplication, Enteryx, EsophyX, Gatekeeper, Plexiglas Microspheres, NDO Plicator System, Radiofrequency Esophageal Treatment, Stretta Open a PDF 7.01.45 2020-04-15 Digestive System (Gastroenterology)
Transcranial Magnetic Stimulation: Deep TMS device, MagVita TMS, NeuroStar TMS device, rTMS, TMS Open a PDF 3.01.09 2020-02-26 Behavioral Health (Psychology)
Transcranial Doppler Ultrasound Open a PDF 6.01.18 2020-01-22 Radiology (x-rays) & Imaging
Showing 1– 20 of 295 Results