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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 07, 2023 | Aug 20, 2024 | Use of a u.s. food and drug administration (fda) cleared or approved automated insulin delivery system... | Ver |
| 01.001.025 | Tumor Treating Fields Therapy | Aug 09, 2023 | Aug 20, 2024 | Tumor treating fields therapy to treat glioblastoma multiforme (gbm) is considered medically necessary as... | Ver |
| 01.001.026 | Cooling Devices Used in the Outpatient Setting | Apr 15, 2024 | Apr 20, 2025 | Circulating and noncirculating cooling devices are considered investigational. combination circulating... | 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 05, 2023 | Sep 20, 2024 | Electrical or magnetic stimulation of the pelvic floor muscles (pelvic floor stimulation) as a treatment for... | Ver |
| 01.002.001 | Certificate Of Evidence Therapies Of parenteral Nutrition and Enteral Nutrition | Jul 01, 2024 | Retired | This certificate must be presented at the time of requesting enteral nutrition services and/or parenteral.... | Ver |
| 01.002.004 | Negative Pressure Wound Therapy in the Outpatient Setting | Oct 26, 2023 | Oct 20, 2024 | 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 | Jul 15, 2024 | Jul 20, 2025 | The use of freespira is considered investigational for all indications including treatment of panic disorder... | Ver |
| 01.003.001 | Orthotics | Jul 01, 2024 | Retired | Orthotic devices are considered medically necessary when prescribed by a qualified provider to be used for... | 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 | I. prótesis e implantes quirúrgicos que se consideran para pago: a. prótesis articulaciones artificiales... | Ver |
| 01.005.001 | Orthopedic Appliances | Jul 01, 2024 | Retired | Codes according to negotiation with the department of hospitals and institutions, and the coordinator of the... | 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 | Impedancia eléctrica en el barrido del seno es un procedimiento que no se considera para pago, ya que una... | Ver |
