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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 |
|---|---|---|---|---|---|
| 07.001.065 | Artificial Intervertebral Disc: Lumbar Spine | May 20, 2024 | May 20, 2025 | Total disc replacement, using an artificial intervertebral disc designed for the lumbar spine, is proposed as... | Ver |
| 07.001.066 | Risk-Reducing Mastectomy | Oct 07, 2024 | Aug 20, 2025 | Risk-reducing mastectomy is defined as the removal of the breast in the absence of malignant disease to... | Ver |
| 07.001.067 | Nerve Graft With Radical Prostatectomy | May 16, 2024 | May 20, 2025 | Nerve grafting at the time of radical prostatectomy, most commonly using the sural nerve, has been proposed... | Ver |
| 07.001.069 | Isolated Limb Perfusion/Infision for Malignant Melanoma | Apr 15, 2019 | Policy Archived | Isolated limb perfusion (ilp) when used as a therapeutic treatment of local recurrence of nonresectable... | Ver |
| 07.001.070 | TONSILECTOMIA ASISTIDA POR LASER | May 16, 2016 | Policy Archived | Tonsilectomia asistida por láser realizada en una o más sesiones no procede para pago. tonsilectomia... | Ver |
| 07.001.071 | Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors | Jan 08, 2025 | Oct 20, 2025 | In radiofrequency ablation (rfa), a probe is inserted into the center of a tumor; then, prong-shaped,... | Ver |
| 07.001.072 | Axial Lumbosacral Interbody Fusion | May 16, 2024 | May 20, 2025 | Axial lumbosacral interbody fusion is considered... | Ver |
| 07.001.073 | Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers) | May 12, 2024 | May 20, 2025 | Interspinous and interlaminar implants (spacers) stabilize or distract the adjacent lamina and/or spinous... | Ver |
| 07.001.074 | Facet Joint Denervation | Dec 04, 2024 | Dec 20, 2025 | Nonpulsed radiofrequency denervation of cervical facet joints (c3-4 and below) and lumbar facet joints is... | Ver |
| 07.001.075 | Extracranial Carotid Artery Stenting | Jun 07, 2024 | Jun 20, 2025 | Carotid angioplasty with associated stenting and embolic protection may be considered medically necessary in... | Ver |
| 07.001.076 | Saturation Biopsy for Diagnosis, Staging, and Management of Prostate Cancer | Aug 12, 2024 | Aug 20, 2025 | Saturation biopsy is considered investigational in the diagnosis, staging, and management of prostate... | Ver |
| 07.001.077 | Plugs for Anal Fistula Repair | Dec 12, 2024 | Dec 20, 2025 | Biosynthetic fistula plugs, including plugs made of porcine small intestine submucosa or of synthetic... | Ver |
| 07.001.079 | Occipital Nerve Stimulation | May 20, 2024 | May 20, 2025 | Occipital nerve stimulation is considered investigational for all... | Ver |
| 07.001.080 | Surgical Treatment of Femoroacetabular Impingement | May 12, 2024 | May 20, 2025 | Open or arthroscopic treatment of femoroacetabular impingement may be medically necessary when all of the... | Ver |
| 07.001.081 | Laser Treatment of Port Wine Stains | Aug 24, 2022 | Policy Archived | Laser treatment of port wine stains in the presence of functional impairment related to the port wine stains... | Ver |
| 07.001.082 | Bronchial Valves | Jul 18, 2024 | Jul 20, 2025 | Bronchial valves are considered investigational in all situations including, but not limited to: treatment... | Ver |
| 07.001.083 | SURGERY OF PARANASAL SINUSES GUIDED BY IMAGES | Nov 11, 2020 | Policy Archived | Image-guided surgery is recognized for payment for the following indications: revision of surgery on the... | Ver |
| 07.001.084 | FUSION VERTEBRAL LUMBAR MINIMAMENTE INVASIVA | Aug 22, 2017 | Policy Archived | Los siguientes procedimientos se reconocen para pago: fusión anterior: alif-abierto fusión posterior:... | Ver |
| 07.001.085 | Autologous Fat Grafting to the Breast and Adipose-Derived Stem Cells | Oct 26, 2020 | Policy Archived | The use of autologous fat grafting to the breast, with or without adipose-derived stem cells, is considered... | Ver |
| 07.001.086 | Image-Guided Minimally Invasive Decompression for Spinal Stenosis | May 20, 2024 | May 20, 2025 | Image-guided minimally invasive spinal decompression is... | Ver |
