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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 |
|---|---|---|---|---|---|
| 01.001.024 | 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 |
| 01.001.025 | Tumor Treating Fields Therapy | Aug 19, 2024 | Aug 20, 2025 | Tumor treating fields therapy to treat glioblastoma multiforme (gbm) is considered medically necessary as... | Ver |
| 01.001.026 | Cooling & Heating Devices Used in the Outpatient Setting | Oct 24, 2024 | Oct 20, 2025 | For individuals who have pain and/or swelling after knee surgery who receive a cooling device, the evidence... | Ver |
| 01.001.027 | Interferential Current Stimulation | Jul 15, 2024 | Jul 20, 2025 | Interferential current stimulation is... | Ver |
| 01.001.028 | Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis | Apr 15, 2024 | Apr 20, 2025 | Postsurgical home use of limb compression devices for vte prophylaxis may be considered medically... | Ver |
| 01.001.029 | Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence | Sep 09, 2024 | Sep 20, 2025 | Electrical or magnetic stimulation of the pelvic floor muscles (pelvic floor stimulation) as a treatment for... | Ver |
| 01.002.004 | Negative Pressure Wound Therapy in the Outpatient Setting | Oct 24, 2024 | Oct 20, 2025 | Initiation of powered negative pressure wound therapy an initial therapeutic trial of not less than 2... | Ver |
| 01.002.005 | Materials or Surgical Medical Supplies | Nov 11, 2020 | Policy Archived | Surgical medical supplies or materials are considered for payment if they meet the following criteria. •... | Ver |
| 01.002.006 | Digital Health Technologies: Therapeutic Applications | Aug 28, 2024 | Aug 20, 2025 | The use of freespira is considered investigational for all indications including treatment of panic disorder... | Ver |
| 01.003.004 | Powered Exoskeleton for Ambulation in Patients With Lower-Limb Disabilities | Apr 15, 2024 | Apr 20, 2025 | Use of a powered exoskeleton for ambulation in patients with lower-limb disabilities is... | Ver |
| 01.003.005 | Patient-Controlled End of Range Motion Stretching Devices | Apr 08, 2024 | Apr 20, 2025 | Patient-controlled end range of motion stretching devices are... | Ver |
| 01.004.001 | PROTÉSIS E IMPLANTES | Nov 21, 2016 | Policy Archived | El implante es un objeto, material o artefacto que se coloca dentro del cuerpo. una prótesis es un... | Ver |
| 01.005.002 | LOWER LIMB PROSTHESIS | Nov 10, 2021 | Policy Archived | Lower limb prosthesis complies with triple-s medical criteria for coverage when the following general... | Ver |
| 02.001.001 | Extracorporeal Shock Wave Treatment for Plantar Fasciitis and Other Musculoskeletal Conditions | Jul 15, 2024 | Jul 20, 2025 | Extracorporeal shock wave therapy using either a high- or low-dose protocol or radial extracorporeal shock... | Ver |
| 02.001.002 | Immunotherapy for Allergies | Jul 08, 2022 | Policy Archived | Immunotherapy for allergies is considered for payment in patients with hypersensitivity that cannot be... | Ver |
| 02.001.004 | Optical Diagnostic Devices for Evaluating Skin Lesions Suspected of Malignancy | Oct 22, 2020 | Policy Archived | Dermatoscopy, using either direct inspection, digitization of images, or computer-assisted analysis, is... | Ver |
| 02.001.005 | IMPEDANCIA ELECTRICA EN EL BARRIDO DEL SENO | May 06, 2016 | Policy Archived | El uso de la impedancia eléctrica en el barrido del seno envuelve la trasmisión continua de electricidad al... | Ver |
| 02.001.006 | Prolotherapy | Dec 09, 2024 | Dec 20, 2025 | Prolotherapy is considered investigational as a treatment of musculoskeletal... | Ver |
| 02.001.007 | ANTIBIOTICOS EN AEROSOL COMO TRATAMIENTO DE LA SINUSITIS CRONICA | Jun 28, 2016 | Policy Archived | Tratamiento de la sinusitis crónica o exacerbaciones agudas de la sinusitis crónica con antibióticos en... | Ver |
| 02.001.008 | MONITOREO DEL FLUJO SANGUÍNEO CEREBRAL REGIOL USANDO U SONDA TERMICA | May 06, 2016 | Policy Archived | Monitoreo de la circulación cerebral usando electrodos termales no se considera para pago. no hay datos... | Ver |
