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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
07.001.123 Hydrogel Spacer use During Radiotherapy for Prostate Cancer Aug 08, 2023 Aug 20, 2024 Hydrogel spacer use radiotherapy for prostate cancer may be considered medically necessary in individuals... Ver
07.001.124 Semi-Implantable and Fully Implantable Middle Ear Hearing Aids Mar 07, 2024 Mar 20, 2025 Semi-implantable and fully implantable middle ear hearing aids are... Ver
07.001.125 Surgical Deactivation of Headache Trigger Sites Mar 07, 2024 Mar 20, 2025 Surgical deactivation of trigger sites is considered investigational for the treatment of migraine and... Ver
07.001.126 Handheld Radiofrequency Spectroscopy for Intraoperative Assessment of Surgical Margins During Breast-Conserving Surgery Mar 07, 2024 Mar 20, 2025 Handheld radiofrequency spectroscopy for intraoperative assessment of surgical margins during... Ver
07.001.127 Surgery for Groin Pain in Athletes Mar 07, 2024 Mar 20, 2025 Surgical treatment of groin pain in athletes (also known as athletic pubalgia, gilmore groin, osteitis pubis,... Ver
07.001.128 Balloon Dilation of the Eustachian Tube Oct 11, 2023 Oct 20, 2024 Balloon dilation of the eustachian tube (bdet) for treatment of chronic obstructive eustachian tube... Ver
07.001.129 Synthetic Cartilage Implants for Joint Pain Oct 11, 2023 Aug 20, 2024 Synthetic cartilage implants are considered investigational for the treatment of articular cartilage... Ver
07.001.132 RHINOPLASTY Nov 10, 2021 Policy Archived Rhinoplasty rhinoplasty may be considered for payment only in the following limited situations:... Ver
07.001.133 Radiofrequency Coblation Tenotomy for Musculoskeletal Conditions Jan 08, 2024 Jan 20, 2025 Radiofrequency coblation tenotomy is considered investigational as a treatment for musculoskeletal... Ver
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 investigational.... Ver
07.001.143 Responsive Neurostimulation for the Treatment of Refractory Focal Epilepsy May 10, 2024 May 20, 2025 Responsive neurostimulation may be considered medically necessary for individuals with focal epilepsy who... Ver
07.001.146 Discectomy Oct 26, 2023 Oct 20, 2024 Lumbar discectomy traditional approach (open) automated percutaneous discectomy automated endoscopic... Ver
07.001.148 Endovascular Therapies for Extracranial Vertebral Artery Disease Jun 18, 2024 Jun 20, 2025 Endovascular therapy, including percutaneous transluminal angioplasty with or without stenting, is... Ver
07.001.151 Prostatic Urethral Lift Sep 08, 2023 Sep 20, 2024 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 Sep 18, 2023 Sep 20, 2024 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

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