View Medical Policies

Showing 1– 20 of 270 Results
Title Last Updated Category
Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy (Effective 2023-03-15) Open a PDF 6.01.12 2023-01-26 Radiation Treatment
Gene Expression Analysis for Prostate Cancer Management Open a PDF 2.02.48 2023-01-25 Genetic Disease (Inherited Disease)
Transcranial Doppler Ultrasound Open a PDF 6.01.18 2023-01-13 Radiology (x-rays) & Imaging
Temporomandibular Joint Disorders (TMJD) Open a PDF 11.01.17 2023-01-13 Bone & Joints (Orthopedic)
Sleep Studies Open a PDF 2.01.28 2023-01-13 Sleep Medicine
Sacroiliac Joint Fusion/Stabilization: Open and Percutaneous Methods Open a PDF 7.01.93 2023-01-13 Bone & Joints (Orthopedic)
Psychological Testing Open a PDF 3.01.02 2023-01-13 Behavioral Health (Psychiatry/Psychology)
Prolotherapy Open a PDF 8.01.10 2023-01-13 Bone & Joints (Orthopedic)
Posturography Open a PDF 2.01.20 2023-01-13 Ear, Nose & Throat (Otorhinolaryngology)
Percutaneous Intradiscal Electrothermal Annuloplasty (IDET/IDTA, PIRFT, Biacuplasty) and Intradiscal Injections Open a PDF 7.01.17 2023-01-13 Bone & Joints (Orthopedic)
Medically Necessary Services Open a PDF 11.01.15 2023-01-13 Miscellaneous
Measurement of Serum Antibodies to Tumor Necrosis Factor Blockers Open a PDF 2.02.47 2023-01-13 Lab Tests (pathology)
Spinal Manipulation Under Anesthesia Open a PDF 7.01.76 2023-01-13 Bone & Joints (Orthopedic)
Lysis of Epidural Adhesions (Epidural Adhesiolysis) Open a PDF 7.01.73 2023-01-13 Bone & Joints (Orthopedic)
Management of Dry Eye Syndrome and Meibomian Gland Dysfunction (e.g., LipiFlow) Open a PDF 9.01.19 2023-01-13 Eyes (Ophthalmology)
Intervertebral Disc Decompression: Laser (Laser Discectomy) and Radiofrequency Coblation (Disc Nucleoplasty) Techniques Open a PDF 7.01.62 2023-01-13
Immunizations Open a PDF 2.01.42 2023-01-13 Vaccines (Immunizations)
Treatment of Hirsutism/ Hypertrichosis (Hair Removal) Open a PDF 2.01.38 2023-01-13 Cosmetic / Reconstructive Surgery
Genetic Testing for Germline Mutations of the RET Proto Oncogene in Medullary Carcinoma of the Thyroid Open a PDF 2.02.07 2023-01-13 Genetic Disease (Inherited Disease)
Showing 1– 20 of 270 Results


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