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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 |
|---|---|---|---|---|---|
| 07.001.100 | Cryosurgical Ablation of Primary or Metastatic Liver Tumors | Oct 10, 2023 | Oct 20, 2024 | 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 18, 2023 | Oct 20, 2024 | 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 |
| 07.001.110 | Blepharoplasty | Nov 09, 2022 | Policy Archived | Blepharoplasty or blepharoplasty repair is covered for payment if the following conditions are met: 1.... | Ver |
| 07.001.112 | Ablation of Peripheral Nerves to Treat Pain | Oct 16, 2023 | Oct 20, 2024 | Radiofrequency ablation of peripheral nerves to treat pain associated with knee osteoarthritis or plantar... | Ver |
| 07.001.114 | Bioengineered Skin and Soft Tissue Substitutes | Apr 19, 2024 | Feb 20, 2025 | Breast reconstructive surgery using allogeneic acellular dermal matrix productsa (including each of the... | Ver |
| 07.001.115 | Vertical Expandable Prosthetic Titanium Rib | May 20, 2024 | May 20, 2025 | Use of the vertical expandable prosthetic titanium rib is considered medically necessary in the treatment... | Ver |
| 07.001.116 | ROUTINE CARE SERVICES OF THE FOOT | Nov 09, 2022 | Policy Archived | Triple-s considers for routine foot care services when: · the provider has the proper qualifications.... | Ver |
| 07.001.117 | Minimally Invasive Ablation Procedures for Morton and Other Peripheral Neuromas | Jul 18, 2024 | Jul 20, 2025 | Minimally invasive ablation procedures, including intralesional alcohol injection, radiofrequency ablation,... | Ver |
| 07.001.118 | Percutaneous Electrical Nerve Stimulation, Percutaneous Neuromodulation Therapy, and Restorative Neurostimulation Therapy | Jul 17, 2024 | Jul 20, 2025 | Percutaneous electrical neurostimulation is considered investigational. percutaneous neuromodulation... | Ver |
| 07.001.119 | Surgical Treatments for Breast Cancer-Related Lymphedema | Oct 17, 2023 | Oct 20, 2024 | Lymphatic physiologic microsurgery to treat lymphedema (including, but not limited to, lymphatico-lymphatic... | Ver |
| 07.001.120 | Facet Arthroplasty | May 16, 2024 | May 20, 2025 | Total facet arthroplasty in individuals with lumbar spinal stenosis undergoing spinal decompression is... | Ver |
| 07.001.121 | Absorbable Nasal Implant for Treatment of Nasal Valve Collapse | Nov 15, 2023 | Nov 20, 2024 | The insertion of an absorbable lateral nasal implant for the treatment of symptomatic nasal valve collapse is... | Ver |
| 07.001.122 | Adipose-Derived Stem Cells in Autologous Fat Grafting to the Breast | Feb 12, 2024 | Feb 20, 2025 | The use of adipose-derived stem cells in autologous fat grafting to the breast is considered investigational.... | Ver |
