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 |
|---|---|---|---|---|---|
| 06.001.062 | Coronary Computed Tomography Angiography With Selective Noninvasive Fractional Flow Reserve | Jun 19, 2023 | Jun 20, 2024 | The use of noninvasive fractional flow reserve following a positive coronary computed tomography angiography... | Ver |
| 06.001.063 | Therapeutic Radiopharmaceuticals in Oncology | Aug 07, 2023 | Aug 20, 2024 | Lutetium 177 initial treatment lutetium 177 (lu 177) dotatate treatment is considered medically... | Ver |
| 06.001.064 | Thermography | Oct 12, 2023 | Oct 20, 2024 | The use of all forms of thermography is... | Ver |
| 06.001.068 | Myocardial Sympathetic Innervation Imaging in Patients With Heart Failure | Oct 11, 2023 | Oct 20, 2024 | Myocardial sympathetic innervation imaging with iodine 123 meta-iodobenzylguanidine is considered... | Ver |
| 06.001.069 | Whole Body Dual X-Ray Absorptiometry to Determine Body Composition | Oct 12, 2023 | Oct 20, 2024 | Dual-energy x-ray absorptiometry body composition studies are considered... | Ver |
| 06.001.070 | Magnetic Resonance Imaging to Monitor the Integrity of Silicone Gel-Filled Breast Implants | Oct 05, 2021 | Policy Archived | Magnetic resonance imaging may be considered medically necessary to confirm the clinical diagnosis of rupture... | Ver |
| 06.001.076 | Radioimmunoscintigraphy (Monoclonal Antibody Imaging) With Indium 111 Capromab Pendetide for Prostate Cancer | Nov 10, 2020 | Policy Archived | Radioimmunoscintigraphy using indium 111 capromab pendetide (prostascint®) is considered investigational for... | Ver |
| 06.001.077 | Radioembolization for Primary and Metastatic Tumors of the Liver | Aug 14, 2023 | Aug 20, 2024 | Radioembolization may be considered medically necessary to treat primary hepatocellular carcinoma that is... | Ver |
| 06.001.078 | Adjunctive Techniques for Screening and Surveillance of Barrett Esophagus and Esophageal Dysplasia | Sep 08, 2023 | Sep 20, 2024 | Wide-area transepithelial sampling with three-dimensional computer-assisted analysis (wats3d) is... | Ver |
| 07.001.001 | Insulin Pump | Nov 14, 2018 | Nov 14, 2019 | The use of the insulin pump is considered for payment for adults and pediatric population with diabetes under... | Ver |
| 07.001.002 | Implantable Infusion Pump for Pain and Spasticity | Mar 11, 2020 | Mar 11, 2021 | Implantable infusion pumps are considered medically necessary when used to deliver drugs having u. food and... | Ver |
| 07.001.003 | Breast Duct Endoscopy | May 07, 2019 | Policy Archived | Breast duct endoscopy is a technique that provides for direct visual examination of the breast ducts through... | Ver |
| 07.001.004 | Percutaneous Balloon Valvuloplasty | Dec 20, 2023 | Policy Archived | Pulmonic balloon valvotomy for pulmonary stenosis percutaneous balloon valvuloplasty may be considered... | Ver |
| 07.001.005 | Decompression of the Intervertebral Disc Using Laser Energy (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty) | May 19, 2023 | Policy Archived | Laser discectomy and radiofrequency coblation (disc nucleoplasty) are considered investigational as... | Ver |
| 07.001.006 | Cryoablation of Tumors Located in the Kidney, Lung, Breast, Pancreas, or Bone | Aug 09, 2023 | Aug 20, 2024 | Cryosurgical ablation may be considered medically necessary to treat localized renal cell carcinoma that is... | Ver |
| 07.001.007 | Gastric Electrical Stimulation | Mar 05, 2024 | Mar 20, 2025 | Gastric electrical stimulation is considered investigational for the treatment of gastroparesis of diabetic,... | Ver |
| 07.001.008 | Endovascular Stent Grafts for Disorders of the Thoracic Aorta | Nov 17, 2023 | Jul 20, 2024 | Endovascular stent grafts using devices approved by u.s. food and drug administration (fda) may be... | Ver |
| 07.001.009 | Computer-Assisted Navigation for Orthopedic Procedures | May 04, 2023 | May 20, 2024 | Computer-assisted surgical navigation for orthopedic procedures is considered... | Ver |
| 07.001.010 | ARTROPLASTIA DE CADERA POR METODO MINIMAMENTE INVASIVO | May 16, 2016 | Policy Archived | La artroplastia minimamente invasiva para reemplazo de cadera o reemplazo de rodilla se considera para pago... | Ver |
| 07.001.011 | Transurethral Water Vapor Thermal Therapy and Transurethral Water Jet Ablation (Aquablation) for Benign Prostatic Hypertrophy | Jul 10, 2023 | Jul 20, 2024 | Transurethral water vapor thermal therapy is considered investigational as a treatment of benign prostatic... | Ver |
