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Políticas Médicas
Las políticas médicas son documentos que definen el reconocimiento de cubierta para tecnologías, procedimientos y tratamientos. Las declaraciones de necesidad médica en las políticas, sobre si una tecnología, procedimiento, tratamiento, suplido, equipo, medicamento u otro servicio mejora el resultado en la salud de la población para la cual dicha tecnología o tratamiento fue diseñado se basan en evidencia científica, estudios clínicos y opiniones profesionales de nuestros proveedores y de las organizaciones médicas reconocidas.
Cada documento desplegado en este sitio Web se provee con propósitos informativos solamente y no es una autorización, explicación de beneficios o un contrato. El recibir beneficios está sujeto a la satisfacción de todos los términos y condiciones de la cubierta. La tecnología médica cambia constantemente y nos reservamos el derecho de revisar y actualizar nuestras políticas periódicamente.
| ID | Título | Última Revisión | Siguiente Revisión | Descripción | Acceso |
|---|---|---|---|---|---|
| 01.001.020 | Transcutaneous Electrical Nerve Stimulation | Jan 07, 2025 | Jan 20, 2026 | A trial of transcutaneous electrical nerve stimulation (tens) of at least 30 days may be... | Ver |
| 01.001.024 | Artificial Pancreas Device Systems | Aug 05, 2024 | Aug 20, 2025 | Policy statements use of a u.s. food and drug administration (fda) cleared or approved automated insulin... | Ver |
| 01.001.027 | Interferential Current Stimulation | Jul 15, 2024 | Jul 20, 2025 | Interferential current stimulation is... | Ver |
| 02.001.015 | Paraspinal Surface Electromyography to Evaluate and Monitor Back Pain | Jul 15, 2024 | Jul 20, 2025 | Paraspinal surface electromyography is considered investigational as a technique to diagnose or monitor back... | Ver |
| 02.001.020 | Endovascular Procedures for Intracranial Arterial Disease (Atherosclerosis and Aneurysms) | May 13, 2024 | May 20, 2025 | Intracranial arterial disease includes thromboembolic events, vascular stenoses, and aneurysms. endovascular... | Ver |
| 02.001.026 | Electromyography and Nerve Conduction Studies | Sep 09, 2024 | Jul 20, 2025 | Electromyography (emg) and nerve conduction studies (ncs), also collectively known as an electrodiagnostic... | Ver |
| 02.001.031 | Biofeedback as a Treatment of Chronic Pain | Dec 09, 2024 | Dec 20, 2025 | Biofeedback as a treatment of chronic pain, including but not limited to low back pain,... | Ver |
| 02.001.077 | Epidural Steroid Injections for Neck or Back Pain | Dec 20, 2024 | Dec 20, 2025 | Epidural steroid injections performed with fluoroscopic guidance may be considered medically necessary for... | Ver |
| 02.001.087 | Low-Dose Radiotherapy for Non-Oncologic Indications | Nov 19, 2024 | Nov 20, 2025 | Low-dose radiotherapy is considered investigational for the treatment of osteoarthritis. low-dose... | Ver |
| 02.001.106 | High Intensity Laser Therapy for Chronic Musculoskeletal Pain Conditions and Bell’s Palsy | Aug 09, 2024 | Aug 20, 2025 | High intensity laser therapy (hilt) for treatment of chronic musculoskeletal pain is considered... | Ver |
| 02.002.018 | Progenitor Cell Therapy for the Treatment of Damaged Myocardium due to Ischemia | Jul 18, 2024 | Policy Archived | Progenitor cell therapy, including but not limited to skeletal myoblasts or hematopoietic cells, is... | Ver |
| 02.007.004 | Somatosensory evoked potential studies visual/auditory | Nov 10, 2021 | Policy Archived | Triple-s will consider for payment studies of evoked potentials when they are performed with the purpose of:... | Ver |
| 05.001.004 | Botulinum Toxin | Nov 04, 2024 | Nov 20, 2025 | The use of botulinum toxin may be considered medically necessary for the following:... | Ver |
| 05.001.015 | Advanced Therapies for Pharmacologic Treatment of Pulmonary Hypertension | Dec 20, 2024 | Dec 20, 2025 | Pulmonary arterial hypertension (pah) combination therapy for the treatment of pah (world health... | Ver |
| 06.001.039 | Dynamic Spinal Visualization and Vertebral Motion Analysis | Oct 08, 2024 | Policy Archived | The use of dynamic spinal visualization is considered investigational. vertebral motion analysis is... | Ver |
| 06.001.045 | Positional Magnetic Resonance Imaging | Dec 14, 2023 | Policy Archived | Positional (nonrecumbent) magnetic resonance imaging is considered investigational, including its use in the... | Ver |
| 06.001.050 | Duplex Sanning | Nov 14, 2019 | Policy Archived | The duplex scanning in the evaluation of the arterial / venous flow of abdominal, pelvic organs and of the... | Ver |
| 06.001.061 | Diagnosis and Treatment of Sacroiliac Joint Pain | Dec 09, 2024 | Dec 20, 2025 | Arthrography of the sacroiliac joint (sij) is considered investigational. injection of anesthetic for... | Ver |
| 07.001.009 | Computer-Assisted Navigation for Orthopedic Procedures | May 17, 2024 | May 20, 2025 | Computer-assisted surgical navigation for orthopedic procedures is considered... | Ver |
| 07.001.014 | Reduction Mammaplasty for Breast-Related Symptoms | Mar 14, 2024 | Mar 20, 2025 | Macromastia, or gigantomastia, is a condition that describes breast hyperplasia or hypertrophy. macromastia... | Ver |
