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 |
|---|---|---|---|---|---|
| 07.001.012 | Whole Gland Cryoablation of Prostate Cancer | Sep 08, 2023 | Sep 20, 2024 | Whole gland cryoablation of the prostate may be considered medically necessary as treatment of clinically... | Ver |
| 07.001.013 | Treatment of Varicose Veins/Venous Insufficiency | Jun 08, 2023 | Jun 20, 2024 | Saphenous veins great or small saphenous veins treatment of the great or small saphenous veins by... | Ver |
| 07.001.014 | Reduction Mammaplasty for Breast-Related Symptoms | Mar 14, 2024 | Mar 20, 2025 | Reduction mammaplasty may be considered medically necessary for the treatment of macromastia when... | Ver |
| 07.001.015 | Reconstructive Breast Surgery/Management of Breast Implants after Mastectomy | Oct 12, 2023 | Jul 20, 2024 | Coverage eligibility of breast implants for the purposes of augmentation may depend on contract language.... | Ver |
| 07.001.016 | STEREOTACTIC, ULTRASOUND & MRI GUIDED BREAST BIOPSY (MIBB) | Nov 09, 2022 | Nov 09, 2023 | Triple-s will consider for payment stereotactic-guided non-palpable breast lesions that are seen only... | Ver |
| 07.001.017 | Ilizarov Bone-Lengthening Procedure | Feb 03, 2021 | Policy Archived | These services are considered for payment in the treatment of the following conditions: • treatment of... | Ver |
| 07.001.018 | Electrical Bone Growth Stimulation of the Appendicular Skeleton | May 19, 2023 | May 20, 2024 | Noninvasive electrical bone growth stimulation may be considered medically necessary for the treatment of... | Ver |
| 07.001.019 | CIRUGÍA DE PUENTES CORORIOS (CABG) | May 10, 2016 | Policy Archived | Al ocurrir una obstrucción de alguna(s) de la(s) arteria(s) principales del corazón, y si no ha ocurrido... | Ver |
| 07.001.021 | Endovascular Stent Grafts for Abdominal Aortic Aneurysms | Nov 09, 2023 | Jun 20, 2024 | The use of endoprostheses approved by the u.s. food and drug administration (fda) as a treatment of abdominal... | Ver |
| 07.001.022 | Surgical Treatment of Snoring and Obstructive Sleep Apnea Syndrome | Jul 06, 2023 | Jul 20, 2024 | Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty, uvulopalatal flap, expansion... | Ver |
| 07.001.023 | Bariatric Surgery | Mar 14, 2024 | Mar 20, 2025 | Bariatric surgery in adults with class iii obesity the following bariatric surgery procedures may be... | Ver |
| 07.001.024 | Transurethral Radiofrequency Needle Ablation of the Prostate | May 08, 2019 | Policy Archived | Transurethral radiofrequency needle ablation of the prostate (tuna) may be considered medically necessary as... | Ver |
| 07.001.025 | Sacral Nerve Neuromodulation/Stimulation | May 22, 2023 | May 20, 2024 | Urinary incontinence and nonobstructive retention criteria a a trial period of sacral nerve... | Ver |
| 07.001.026 | Bronchial Thermoplasty | Jul 10, 2023 | Jul 20, 2024 | Bronchial thermoplasty for the treatment of asthma is considered... | Ver |
| 07.001.027 | Transurethral destruction Of Prostate Tissue Using Microwave Thermotherapy | Jun 23, 2023 | Policy Archived | Transurethral destruction of prostate tissue as a treatment for benign prostatic hyperplasia by microwave... | Ver |
| 07.001.028 | Injectable Bulking Agents for the Treatment of Urinary and Fecal Incontinence | Nov 15, 2023 | Nov 20, 2024 | The use of carbon-coated spheres, calcium hydroxylapatite, polyacrylamide hydrogel, or polydimethylsiloxane... | Ver |
| 07.001.029 | Spinal Cord and Dorsal Root Ganglion Stimulation | May 19, 2023 | May 20, 2024 | Spinal cord stimulation with standard or high-frequency stimulation may be considered medically... | Ver |
| 07.001.030 | Vagus Nerve Stimulation | Mar 15, 2024 | Mar 20, 2025 | Vagus nerve stimulation may be considered medically necessary as a treatment of medically refractory... | Ver |
| 07.001.031 | Policy Name: Deep Brain Stimulation | Aug 21, 2023 | May 20, 2024 | Unilateral deep brain stimulation of the thalamus may be considered medically necessary in individuals with... | Ver |
| 07.001.032 | Phototherapeutic Keratectomy | Jun 23, 2023 | Policy Archived | Phototherapeutic keratectomy is considered for payment when used as an alternative to lamellar keratoplasty... | Ver |
