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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 |
|---|---|---|---|---|---|
| 07.001.088 | Lung Volume Reduction Surgery for Severe Emphysema | Jul 17, 2024 | Jul 20, 2025 | Lung volume reduction surgery (lvrs) is proposed as a treatment option for patients with severe emphysema who... | 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 22, 2024 | Nov 20, 2025 | 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 | Both invasive and noninvasive electrical bone growth stimulators have been investigated as an adjunct to... | Ver |
| 07.001.092 | Interspinous Fixation (Fusion) Devices | May 12, 2024 | May 20, 2025 | Interspinous fixation (fusion) devices are being developed to aid in the stabilization of the spine. they are... | Ver |
| 07.001.094 | Magnetic Esophageal Sphincter Augmentation to Treat Gastroesophageal Reflux Disease | Dec 12, 2024 | Dec 20, 2025 | Magnetic esophageal sphincter augmentation to treat gastroesophageal reflux disease... | 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 | Dec 06, 2024 | Aug 20, 2025 | An integrated system providing magnetic resonance-guided focused ultrasound (mrgfus) treatment is proposed as... | 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 | Sep 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 |
| 07.001.100 | Cryosurgical Ablation of Primary or Metastatic Liver Tumors | Oct 07, 2024 | Oct 20, 2025 | Cryosurgical ablation of either primary or metastatic tumors in the liver is... | Ver |
| 07.001.101 | Subtalar Arthroereisis | May 20, 2024 | May 20, 2025 | Subtalar arthroereisis is considered... | Ver |
| 07.001.102 | Lumbar Spinal Fusion | Oct 15, 2024 | Oct 20, 2025 | Lumbar spinal fusion may be considered medically necessary for any one of the following conditions:... | Ver |
| 07.001.103 | Transcatheter Aortic Valve Implantation for Aortic Stenosis | Mar 15, 2024 | Mar 20, 2025 | Transcatheter aortic valve replacement with a u.s. food and drug administration (fda) approved transcatheter... | Ver |
| 07.001.104 | Transcatheter Pulmonary Valve Implantation | Jul 19, 2024 | Jul 20, 2025 | Transcatheter pulmonary valve implantation with a food and drug administration-approved valve is considered... | Ver |
| 07.001.105 | Electromagnetic Navigational Bronchoscopy | Jul 22, 2024 | Jul 20, 2025 | When flexible bronchoscopy alone, or with endobronchial ultrasound, are considered inadequate to accomplish... | Ver |
| 07.001.107 | Surgical Treatment of Bilateral Gynecomastia | Nov 09, 2022 | Policy Archived | Surgical removal of breast tissue, such as mastectomy or liposuction, as a treatment of gynecomastia, is... | Ver |
| 07.001.108 | Laminectomy | Jul 16, 2024 | Jul 20, 2025 | Cervical laminectomy may be considered medically necessary when all of the following conditions are met:... | Ver |
| 07.001.109 | Vagus Nerve Blocking Therapy for Treatment of Obesity | Apr 09, 2021 | Policy Archived | Intra-abdominal vagus nerve blocking therapy is considered investigational in all situations, including but... | Ver |
