Home & Lifestyle
5 habits to add years to your life
Read more
Medical Policies
Medical policies are documents that define the plan coverage for technologies, procedures and treatments. The statements of medical necessity in the policies, about whether a technology, procedure, treatment, supply, equipment, drug or other service improves the health outcome of the population for which said technology or treatment was designed are based on scientific evidence, clinical studies and professional opinions from our providers and recognized medical organizations.
Each document displayed on this website is provided for informational purposes only and is not an authorization, explanation of benefits, or contract. Receiving benefits is subject to satisfaction of all terms and conditions of coverage. Medical technology is constantly changing, and we reserve the right to periodically review and update our policies.
| ID | Title | Last Review | Next Review | Description | Access |
|---|---|---|---|---|---|
| 01.001.001 | SUMINISTRO DE EQUIPO MEDICO DURADERO Y MATERIALES O SUMINISTROS MEDICO QUIRURGIC | Oct 28, 2017 | Policy Archived | ... | View |
| 01.001.002 | Lista de equipo cuya naturaleza no es primeramente médica | Nov 15, 2016 | Policy Archived | ... | View |
| 01.001.003 | Servicos y artículos con características de lujo y costo adicionalEMD | May 10, 2016 | Policy Archived | ... | View |
| 01.001.005 | External Infusion Pumps | Dec 27, 2019 | Policy Archived | An external infusion pump (eip) is a portable device intended to provide continuous ambulatory drug infusion... | View |
| 01.001.006 | Low Intensity Pulsed Ultrasound Fracture Healing Device | Apr 05, 2024 | Apr 20, 2025 | Low-intensity pulsed ultrasound has been investigated as a technique to accelerate healing of fresh... | View |
| 01.001.007 | BOMBAS DE INFUSION EXTERNA Y QUIMIOTERAPIA EN EL HOGAR | Sep 10, 2024 | Policy Archived | An external infusion pump consists of a portable attachment that has been designed to administer an infusion... | View |
| 01.001.008 | Transtympanic Micropressure Applications As A Treatment Of Meniere Disease | Mar 30, 2020 | Policy Archived | Meniere disease is an idiopathic disorder of the inner ear characterized by episodes of vertigo, fluctuating... | View |
| 01.001.009 | INSUFLATION-MECHANICAL EXSULFATION AS AN AID TO RESPIRATORY MUSCLES | Sep 09, 2020 | Policy Archived | The published data suggest that mi-e can improve the intermediate outcome of peak cough expiratory flow. data... | View |
| 01.001.010 | Continuous Passive Motion In The Home Setting | Apr 10, 2024 | Apr 20, 2025 | Continuous passive motion devices are used to keep a joint in motion without patient assistance. continuous... | View |
| 01.001.011 | Adjustable Cranial Orthoses For Positional Plagiocephaly And Craniosynostoses | Apr 18, 2024 | Apr 20, 2025 | Cranial orthoses involve an adjustable helmet or band that progressively molds the shape of the infant... | View |
| 01.001.012 | Electrical And Electromagnetic Stimulation For The Treatment Of Arthritis | Apr 15, 2024 | Apr 20, 2025 | <h2 style="break-inside: avoid; break-after: avoid; font-family: arial; font-size: 20px !important;... | View |
| 01.001.013 | Microprocessor-Controlled Prostheses For The Lower Limb | Apr 05, 2024 | Apr 20, 2025 | Microprocessor-controlled prostheses use feedback from sensors to adjust joint movement on a real-time... | View |
| 01.001.014 | MONOCROMATIC ENERGY INFRARED CONTACT IN THE TREATMENT OF SKIN ULCERS, DIABETIC N | Dec 26, 2018 | Policy Archived | Monochromatic infrared energy (mire™) is a therapy that uses pulsed infrared light at a wavelength of... | View |
| 01.001.015 | Estimulación Eléctrica al Umbral Como Tratamiento de Desordenes de Movimiento | May 16, 2016 | Policy Archived | ... | View |
| 01.001.016 | Myoelectric Prosthetic And Orthotic Components For The Upper Limb | Apr 05, 2024 | Apr 20, 2025 | Myoelectric prostheses are powered by electric motors with an external power source. the joint movement of an... | View |
| 01.001.017 | Monitoreo del tiempo de protrombina en el hogar | Nov 30, 2023 | Policy Archived | Patients who are prescribed chronic warfarin anticoagulation need ongoing monitoring that has generally taken... | View |
| 01.001.018 | Oscillatory Devices For The Treatment Of Cystic Fibrosis And Other Respiratory Conditions | Sep 09, 2024 | Jul 20, 2025 | Oscillatory devices are alternatives to the standard daily percussion and postural drainage method of airway... | View |
| 01.001.020 | Transcutaneous Electrical Nerve Stimulation | Jan 07, 2025 | Jan 20, 2026 | Transcutaneous electrical nerve stimulation (tens) describes the application of electrical stimulation to the... | View |
| 01.001.021 | Home Cardiorespiratory Monitoring | Jul 18, 2024 | Jul 20, 2025 | Home cardiorespiratory monitors track respiratory effort and heart rate to detect episodes of apnea. they... | View |
| 01.001.023 | Hemophilia Antihemophilic Factor | Jul 24, 2024 | Policy Archived | The hemophilias are a group of related bleeding disorders that most commonly are inherited. inherited... | View |
