View Medical Policies

Showing 261– 276 of 276 Results
Title Last Updated Category
Genotyping Cytochrome P450 (CYP450) for Drug Metabolism: Amplichip Policy 2.02.30 (posted 9/10/18) Open a PDF 2.02.30 2021-02-16 Genetic Disease (Inherited Disease)
Genotyping or Phenotyping for Thiopurine Methyltransferase (TPMT) for Patients Treated with Azathioprine (6-MP) Open a PDF 2.02.37 2021-02-16 Genetic Disease (Inherited Disease)
Growth Factors for Wound Healing and Other Conditions: Becaplermin, Platelet Derived Growth Factor (PDGF), Platelet Rich Plasma, Regranex Open a PDF 2.01.24 2021-02-16 Skin (Dermatology)
Ketamine for the Treatment of Psychiatric Disorders Open a PDF 3.01.13 2021-02-16 Behavioral Health (Psychiatry/Psychology)
Nuclear Breast Imaging: Breast Specific Gamma Camera, BSGI, Gammagram, Miraluma, Radioimmunoscintigraphy, Scintigraphy, Scintimammography Open a PDF 6.01.02 2021-02-16 Radiology (x-rays) & Imaging
Pancreas Transplant (Pancreas Transplant Alone, Pancreas After Kidney Transplant, Simultaneous Pancreas Kidney Transplant); Islet Cell Transplant Open a PDF 7.02.01 2021-02-16 Transplants
Molecular Testing for the Management of Pancreatic Cysts (e.g.,PancraGEN Pancreatic Risk Classifier) Open a PDF 2.02.39 2021-02-16 Lab Tests (pathology)
Gender Reassignment Surgery: Gender Dysphoria, Gender Identity Disorder (GID), Genital Correction Surgery, Genital Reassignment Surgery, Genital Reconstruction, Gender Realignment Surgery, Gender Confirmation Surgery, Intersex, Transsexualism, Transsexual Surgery Open a PDF 7.01.84 2021-01-26 Miscellaneous
Group Therapy for Mental Health Policy Open a PDF 3.01.08 2021-01-07 Behavioral Health (Psychiatry/Psychology)
Brachytherapy After Breast-Conserving Surgery, as Boost with Whole Breast Irradiation or Alone as Accelerated Partial Breast Irradiation (Effective 2022-03-15) Open a PDF 6.01.30 12/03/2021 Radiation Treatment
Ovarian and Internal Iliac Vein Endovascular Occlusion as a Treatment of Pelvic Congestion Syndrome (Effective 2022-03-15) Open a PDF 4.01.10 12/03/2021 Women's Health (Obstetrics & Gynecology)
Radiofrequency Facet and Sacroiliac Joint Ablation/Denervation Open a PDF 7.01.42 06-24-2021 Bone & Joints (Orthopedic)
Shoulder Arthroplasty (Total, Partial, Reverse) Open a PDF 7.01.95 05-06-2021 Bone & Joints (Orthopedic)
Showing 261– 276 of 276 Results
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