View Medical Policies

Showing 41– 60 of 295 Results
Title Last Updated Category
Signal Averaged Electrocardiogram (SAECG) Open a PDF 2.01.02 2020-02-26 Heart & Blood Vessels (Cardiovascular)
Sialendoscopy Open a PDF 7.01.94 2020-05-08 Ear, Nose & Throat (Otorhinolaryngology)
Shoulder Arthroplasty Open a PDF 7.01.95 2020-01-22 Bone & Joints (Orthopedic)
Sex Specific Services, Gender dysphoria, Gender Identity Disorder, GID, transgender, transsexualism Open a PDF 11.01.26 2020-07-17 Behavioral Health (Psychology)
Sex Offender Treatment Program Open a PDF 3.01.17 2019-09-27 Behavioral Health (Psychology)
Serum Tumor Markers for Diagnosis and Management of Cancer (AFP, CA-125, CA-19-9, CA-15-3, CA 27, CA 29, CEA, HCG, Proteomic) Open a PDF 2.02.10 2019-10-15 Lab Tests (pathology)
Serum Antibodies for the Diagnosis of Inflammatory Bowel Disease, Anti-neurtrophil Cytoplasmic Antibodies, ANCA, ASCA, Serological markers Open a PDF 2.02.19 2020-01-22 Lab Tests (pathology)
Selective Internal Radiation Therapy (SIRT) for Hepatic Tumors (SIR-Spheres, Theraspheres) Open a PDF 7.01.69 2019-08-22 Radiation Treatment
Second Medical and Second Surgical Opinions, Confirmatory Consultation Open a PDF 10.01.10 2020-05-13 Miscellaneous
Screening for Vitamin D Deficiency Open a PDF 2.02.45 2019-08-22 Lab Tests (pathology)
Sacroiliac Joint Fusion, IFUSE® Implant System ,SI-FIX, SImmetry® Sacroiliac Joint Fusion System, Silex™ Sacroiliac Joint Fusion System, SI-LOK® Sacroiliac Joint Fixation System Open a PDF 7.01.93 2020-02-26 Bone & Joints (Orthopedic)
Sacral Nerve Stimulation for Pelvic Floor Dysfunction (Incontinence, Neuromodulation, Urinary Retention) Open a PDF 7.01.10 2020-03-18 Nervous Systems (Neurology)
Responsive Neurostimulation for the Treatment of Refractory Focal Epilepsy Open a PDF 7.01.103 2020-05-08 Nervous Systems (Neurology)
Refractive Procedures (e.g., Artisan, Astigmatic Keratotomy, Clear Lens Extraction, Photorefractive Keratectomy - PRK, INTACS - Corneal Ring Segments, Intracorneal Inlay, Laser-Assisted Subepithelial Keratomileusis - LASIK, Phakic Intraocular Lens) Open a PDF 9.01.08 2019-11-25 Eyes (Ophthalmology)
Reduction Mammaplasty/ Breast Reduction Open a PDF 7.01.39 2019-09-27 Cosmetic / Reconstructive Surgery
Radium-223 (Xofigo) for Treatment of Castration-Resistant Prostate Cancer Open a PDF 6.01.44 2020-06-11 Cancer Treatment (Oncology)
Radiofrequency Tumor Ablation Policy 7.01.32 (posted 9/6/18) Open a PDF 7.01.32 2020-01-16 Cancer Treatment (Oncology)
Radiofrequency Knee Ablation/Denervation Open a PDF 7.01.100 2020-05-08 Bone & Joints (Orthopedic)
Radiofrequency Facet Denervation Open a PDF 7.01.42 2019-08-15 Bone & Joints (Orthopedic)
Quantitative Sensory Testing (QST) Open a PDF 2.01.34 2020-01-22 Nervous Systems (Neurology)
Showing 41– 60 of 295 Results