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 |
|---|---|---|---|---|---|
| 07.001.127 | 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 19, 2023 | May 20, 2024 | Peripheral subcutaneous field stimulation is... | Ver |
| 07.001.143 | Responsive Neurostimulation for the Treatment of Refractory Focal Epilepsy | May 22, 2023 | May 20, 2023 | 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 19, 2023 | Jun 20, 2024 | 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 05, 2023 | May 20, 2024 | 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, 2023 | Jun 20, 2024 | 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 15, 2023 | Nov 20, 2024 | Radiofrequency ablation of the renal sympathetic nerves is considered investigational for the treatment of... | Ver |
| 07.001.160 | Percutaneous Balloon Kyphoplasty, Radiofrequency Kyphoplasty, and Mechanical Vertebral Augmentation | May 19, 2023 | May 20, 2024 | Balloon kyphoplasty may be considered medically necessary for the treatment of symptomatic thoracolumbar... | Ver |
| 07.001.161 | Patient Specific Instrumentation (eg Cutting Guides) for Joint Arthroplasty | May 08, 2023 | May 20, 2024 | 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 19, 2023 | Jun 20, 2024 | Injection of allograft into the intervertebral disc for the treatment of degenerative disc disease is... | Ver |
