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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
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2019-09-19 |
Heart & Blood Vessels (Cardiovascular)
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Total Parenteral Nutrition (TPN), Intradialytic Parenteral Nutrition (IDPN), Intraperitoneal Nutrition (IPN), or Hyperalimentation
Open a PDF
11.01.04
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2020-03-27 |
Food (Nutrition)
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Total Hip Resurfacing, Metal-on-Metal
Open a PDF
7.01.74
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2019-08-15 |
Bone & Joints (Orthopedic)
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Temporomandibular Joint (TMJ) Disease
Open a PDF
11.01.17
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2020-02-21 |
Bone & Joints (Orthopedic)
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Telemedicine and Telehealth
Open a PDF
1.01.49
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2020-04-21 |
Home Care
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Surgical Ventricular Restoration (SVR): DOR Procedure, Surgical Anterioe Endocardial Restoration (SAVER), Ventricular Remodeling
Open a PDF
7.01.71
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2019-11-12 |
Heart & Blood Vessels (Cardiovascular)
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Surgical Ventricular Reduction (e.g., Partial Ventriculectomy, Batista Procedure)
Open a PDF
7.01.31
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2020-05-08 |
Heart & Blood Vessels (Cardiovascular)
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Surgical Stockings (e.g., Gradient Compression/GCS, Jobst, Sigvaris, TEDs) and Compression Garments (e.g., Arm Assist, Belisse Compressure Bra, Lymphedema, Mastectomy, Circaid, Juzo, Reid Sleeves)
Open a PDF
1.01.14
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2020-07-24 |
Durable Medical Equipment & Supplies
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Surgical Management of Sleep Disorders/Sleep Apnea: Airvance®, Atrial overdrive pacing, Aura6000 System, CAPSO, Encore™, HGNS®, Hypoglossal Nerve Stimulation, Inspire II Upper Airway Stimulation System, LAUP, Pillar™, Repose™, Snoreplasty, Somnoplasty, UPPP
Open a PDF
7.01.41
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2020-04-15 |
Sleep Medicine
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Surgical Management of Obesity: Adjustable Gastric Band, Bariatric Surgery, Biliopancreatic Diversion, Duodenal Switch, Endobarrier, Gastric Bypass, Gastric Plication, Imbrication, Lap Band, Restorative Obesity Surgery, Endoluminal [ROSE], Roux-en-Y, Sleeve Gastrectomy, Stomach Stapling, TOGA, Transoral or Vertical Banded Gastroplasty
Open a PDF
7.01.29
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2019-11-12 |
Digestive System (Gastroenterology)
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Superficial Radiation Therapy for Treatment of Skin Cancers (Orthovoltage x-ray, SR-100, Xstrahl-100)
Open a PDF
6.01.43
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2020-06-11 |
Cancer Treatment (Oncology)
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Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy
Open a PDF
6.01.12
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2020-07-17 |
Radiation Treatment
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Standing Devices and Gait Trainers, Stander
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1.01.46
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2020-03-27 |
Durable Medical Equipment & Supplies
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Standard Dialectical Behavioral Therapy (DBT)
Open a PDF
3.01.10
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2019-09-27 |
Behavioral Health (Psychology)
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Spinal Injections (Epidural and Facet Injectins) for Pain Management: Medial Branch Block Policy 7.01.87 (posted 8/16/18)
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7.01.87
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2020-01-22 |
Bone & Joints (Orthopedic)
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Spinal Cord/Dorsal Column Stimulation
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7.01.51
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2020-01-22 |
Bone & Joints (Orthopedic)
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Speech/Language Pathology and Therapy (e.g., Fast ForWord, Lee Silverman Voice Therapy [LSVT-LOUD™], Voice Therapy)
Open a PDF
8.01.13
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2020-07-17 |
Therapy & Rehabilitation
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Small Bowel and Multivisceral Transplants in Adults and Children
Open a PDF
7.02.05
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2020-04-15 |
Transplants
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Skilled Nursing Facility (SNF) Care for Medicare Advantage Members
Open a PDF
11.01.21
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2020-03-27 |
Miscellaneous
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Sinus Ostial Dilation for Treatment of Chronic Sinusitis (e.g., Balloon Sinuplasty), catheter sinusotomy
Open a PDF
7.01.85
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2020-06-11 |
Ear, Nose & Throat (Otorhinolaryngology)
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