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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
07.001.134 Steroid-Eluting Sinus Stents and Implants Mar 07, 2024 Mar 20, 2025 The use of steroid-eluting sinus stents and implants for postoperative treatment following endoscopic sinus... Ver
07.001.139 Peripheral Subcutaneous Field Stimulation May 20, 2024 May 20, 2025 Peripheral subcutaneous field stimulation is a form of neuromodulation intended to treat chronic neuropathic... Ver
07.001.143 Responsive Neurostimulation for the Treatment of Refractory Focal Epilepsy May 10, 2024 May 20, 2025 Approximately one-third of individuals with epilepsy do not respond to typical first-line therapy with... Ver
07.001.146 Discectomy Oct 24, 2024 Oct 20, 2025 Lumbar discectomy traditional approach (open) automated percutaneous discectomy automated endoscopic... Ver
07.001.148 Endovascular Therapies for Extracranial Vertebral Artery Disease Jul 18, 2024 Policy Archived Endovascular therapy, including percutaneous transluminal angioplasty with or without stenting, is... Ver
07.001.151 Prostatic Urethral Lift Sep 11, 2024 Sep 20, 2025 Use of prostatic urethral lift in individuals with moderate-to-severe lower urinary tract obstruction due to... Ver
07.001.152 Magnetic Resonance Imaging-Targeted Biopsy of the Prostate    Oct 23, 2024 Policy Archived Magnetic resonance imaging-targeted biopsy of the prostate may be considered medically necessary for... Ver
07.001.155 Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis Mar 18, 2024 Mar 20, 2025 The use of functional endoscopic sinus surgery is considered medically necessary for individuals with chronic... Ver
07.001.156 Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions May 16, 2024 May 20, 2025 Autologous chondrocyte implantation may be considered medically necessary for the treatment of disabling... Ver
07.001.157 Open and Thoracoscopic Approaches to Treat Atrial Fibrillation and Atrial Flutter (Maze and Related Procedures) Jun 12, 2024 Jun 20, 2025 The maze or modified maze procedure, performed on a non-beating heart during cardiopulmonary bypass with... Ver
07.001.158 Three-Dimensional Printed Orthopedic Implants Sep 09, 2020 Policy Archived Three-dimensional (3d) printed orthopedic implants that have a design that is approved or cleared by the food... Ver
07.001.159 Radiofrequency Ablation of the Renal Sympathetic Nerves as a Treatment for Uncontrolled Hypertension Nov 22, 2024 Nov 20, 2025 Radiofrequency ablation of the renal sympathetic nerves is considered investigational for the treatment of... Ver
07.001.161 Patient Specific Instrumentation (eg Cutting Guides) for Joint Arthroplasty May 20, 2024 May 20, 2025 Use of patient-specific instrumentation (eg, cutting guides) for joint arthroplasty, including but not... Ver
07.001.162 Allograft Injection for Degenerative Disc Disease Jun 18, 2024 Jun 20, 2025 Injection of allograft into the intervertebral disc for the treatment of degenerative disc disease is... Ver
07.001.163 Cryoablation, Radiofrequency Ablation, and Laser Ablation for Treatment of Chronic Rhinitis  Apr 08, 2024 Apr 20, 2025 Chronic rhinitis is a common medical condition that encompasses allergic rhinitis, nonallergic rhinitis, and... Ver
07.001.164 Liposuction for Lipedema and Lymphedema Nov 22, 2024 Nov 20, 2025 Liposuction for lipedema or lymphedema is considered... Ver
07.001.165 Laser Interstitial Thermal therapy for Neurological Conditions Jan 15, 2025 Jan 20, 2026 Laser interstitial thermal therapy (litt) is considered investigational for all neurological indications,... Ver
07.001.166 Uterus Transplantation for Absolute Uterine Factor Infertility Sep 18, 2024 Sep 20, 2025 Uterus transplantation for absolute uterine factor infertility is... Ver
07.001.167 Remote electrical Neuromodulation for Migraines Dec 03, 2024 Nov 20, 2025 Remote electrical neuromodulation for acute migraine or prevention of migraine is... Ver
07.001.168 Surgical Left Atrial Appendage Occlusion Devices for Stroke Prevention in Atrial Fibrillation Sep 18, 2024 Sep 20, 2025 The use of surgical left atrial appendage occlusion devices, including the atriclip device, for stroke... Ver

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