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 |
|---|---|---|---|---|---|
| 06.001.035 | FDG Using Camera-Based Imaging (FDG-SPECT) | Aug 23, 2023 | Policy Archived | Spect is considered for payment to demonstrate myocardial viability. spect is not considered for payment... | Ver |
| 06.001.037 | Scintigraphy of Acute Deep Venous Thrombus | Sep 05, 2019 | Policy Archived | Scintigraphic imaging of acute venous thrombus in the lower extremities may be considered medically necessary... | Ver |
| 06.001.038 | Computed Tomography Perfusion Imaging of the Brain | Oct 04, 2023 | Oct 20, 2024 | Computed tomography perfusion imaging may be considered medically necessary to select patients with anterior... | Ver |
| 06.001.039 | Dynamic Spinal Visualization and Vertebral Motion Analysis | Oct 05, 2023 | Oct 20, 2024 | The use of dynamic spinal visualization is considered investigational. vertebral motion analysis is... | Ver |
| 06.001.040 | Magnetoencephalography/Magnetic Source Imaging | Oct 13, 2021 | Policy Archived | Magnetoencephalography/magnetic source imaging as part of the preoperative evaluation of patients with... | Ver |
| 06.001.041 | Interim Positron Emission Tomography Scanning in Oncology to Detect Early Response During Treatment | Oct 11, 2023 | Oct 20, 2024 | The use of interim fluorine 18 fluorodeoxyglucose positron emission tomography scans to determine response to... | Ver |
| 06.001.042 | Positron Emission Mammography | Nov 05, 2020 | Policy Archived | The use of positron emission mammography is considered investigational for all... | Ver |
| 06.001.043 | Cardiac Applications of Positron Emission Tomography Scanning | Oct 11, 2023 | Oct 20, 2024 | Cardiac positron emission tomography (pet) scanning may be considered medically necessary to assess... | 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 |
| 06.001.046 | Optical Coherence Tomography of the Anterior Eye Segment | Mar 05, 2024 | Mar 20, 2025 | Scanning computerized ophthalmic (eg, optical coherence tomography) imaging of the anterior eye segment is... | Ver |
| 06.001.047 | NON-INVASIVE ARTERIAL VASCULAR STUDIES OF UPPER AND LOWER EXTREMITIES | Oct 14, 2022 | Policy Archived | To perform a duplex scanning it is necessary to perform a real time scan, therefore the billing of a duplex... | Ver |
| 06.001.048 | NON INVASIVE EVALUATION OF EXTRACRANIAL ARTERIES | Nov 09, 2022 | Policy Archived | Non-invasive studies are recognized for payment if the results impact the clinical course of the patient, for... | Ver |
| 06.001.049 | NON INVASIVE VASCULAR STUDIES UPPER AND LOWER EXTREMITIES | Nov 14, 2018 | Policy Archived | To perform a duplex scanning sweep is needed in real time, therefore the billing of a duplex scanning and... | 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 |
| 06.001.051 | Digital Breast Tomosynthesis | Nov 09, 2020 | Nov 09, 2021 | Digital breast tomosynthesis (dbt) uses modified digital mammography (dm) equipment to obtain additional... | Ver |
| 06.001.053 | Selected Positron Emission Tomography Technologies for Evaluation of Alzheimer Disease | Nov 13, 2023 | Nov 20, 2024 | Amyloid beta imaging with positron emission tomography (pet) to predict conversion to alzheimer disease is... | Ver |
| 06.001.057 | INTENSITY MODULATED RADIATION THERAPY (IMRT) | Oct 26, 2023 | Oct 20, 2024 | Imrt is considered reasonable and medically necessary in instances where sparing the surrounding normal... | Ver |
| 06.001.059 | Dopamine Transporter Single-Photon Emission Computed Tomography | Nov 13, 2023 | Nov 20, 2024 | Dopamine transporter imaging with single-photon emission computed tomography may be considered medically... | Ver |
| 06.001.060 | Endobronchial Ultrasound for Diagnosis and Staging of Lung Cancer | Oct 18, 2023 | Oct 20, 2024 | Endobronchial ultrasound-guided transbronchial needle aspiration (ebus-tbna) may be considered medically... | Ver |
| 06.001.061 | Diagnosis and Treatment of Sacroiliac Joint Pain | Dec 04, 2023 | Dec 20, 2024 | Arthrography of the sacroiliac joint (sij) is considered investigational. injection of anesthetic for... | Ver |
