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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 |
|---|---|---|---|---|---|
| 07.001.077 | Plugs for Anal Fistula Repair | Dec 13, 2023 | Dec 20, 2024 | 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 |
| 07.001.088 | Lung Volume Reduction Surgery for Severe Emphysema | Jul 17, 2024 | Jul 20, 2025 | Lung volume reduction surgery as a treatment for emphysema may be considered medically necessary in... | Ver |
| 07.001.089 | SEPTOPLASTY | Nov 10, 2021 | Policy Archived | Septoplasty it is considered medically necessary when any of the following clinical conditions is present:... | Ver |
| 07.001.090 | Microwave Tumor Ablation | Nov 15, 2023 | Nov 20, 2024 | Microwave ablation of primary or metastatic hepatic tumors may be considered medically necessary under the... | Ver |
| 07.001.091 | Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures | May 16, 2024 | May 20, 2025 | Either invasive or noninvasive methods of electrical bone growth stimulation may be considered medically... | Ver |
| 07.001.092 | Interspinous Fixation (Fusion) Devices | May 12, 2024 | May 20, 2025 | Interspinous fixation (fusion) devices are considered investigational for any indication, including but not... | Ver |
| 07.001.094 | Magnetic Esophageal Sphincter Augmentation to Treat Gastroesophageal Reflux Disease | Dec 13, 2023 | Dec 20, 2024 | Magnetic esophageal sphincter augmentation to treat gastroesophageal reflux disease is investigational.... | Ver |
| 07.001.095 | COBLATION ASSISTED TONSILECTOMY | Nov 10, 2021 | Policy Archived | Tonsillectomy by coblation is not considered for additional payment for the treatment of any of the following... | Ver |
| 07.001.096 | Magnetic Resonance-Guided Focused Ultrasound | Aug 08, 2023 | Aug 20, 2024 | Magnetic resonance-guided high-intensity ultrasound ablation may be considered medically necessary for pain... | Ver |
| 07.001.097 | Transcatheter Closure of Patent Ductus Arteriosus | Jun 13, 2019 | Policy Archived | Transcatheter closure of a patent ductus arteriosus using an fda-approved device may be considered medically... | Ver |
| 07.001.098 | Debridment | Jul 09, 2024 | Policy Archived | Triple-s salud considers payment for debridement when provided by the surgeon for the management of ulcers or... | Ver |
| 07.001.099 | Hip Resurfacing | May 16, 2024 | May 20, 2025 | Metal-on-metal total hip resurfacing with a device system approved by the u.s. food and drug administration... | Ver |
