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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
07.001.159 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 20, 2024 Retired Policy 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 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 Cryoablation for chronic rhinitis (allergic or nonallergic) is considered investigational. radiofrequency... Ver
07.001.164 Liposuction for Lipedema and Lymphedema Nov 16, 2023 Nov 20, 2024 Liposuction for lipedema or lymphedema is considered... Ver
07.001.165 Laser Interstitial Thermal therapy for Neurological Conditions Jan 09, 2024 Jan 20, 2025 Laser interstitial thermal therapy (litt) is considered investigational for all neurological indications,... Ver
07.001.166 Uterus Transplantation for Absolute Uterine Factor Infertility Sep 12, 2023 Sep 20, 2024 Uterus transplantation for absolute uterine factor infertility is considered... Ver
07.001.167 Remote electrical Neuromodulation for Migraines Jun 06, 2024 Jun 20, 2025 Remote electrical neuromodulation for acute migraine is... Ver
07.001.168 Surgical Left Atrial Appendage Occlusion Devices for Stroke Prevention in Atrial Fibrillation Sep 14, 2023 Sep 20, 2024 The use of surgical left atrial appendage occlusion devices, including the atriclip device, for stroke... Ver
07.001.169 Temporarily Implanted Nitinol Device (iTind) for Benign Prostatic Hyperplasia Feb 07, 2024 Feb 20, 2025 The use of a temporarily implanted nitinol device (eg, itind) is considered investigational as a treatment of... Ver
07.001.170 Lithotripsy for Salivary Stones Oct 26, 2023 Jan 09, 2024 The following are investigational for treating salivary stones due to insufficient... Ver
07.001.171 Laser Surgery of the Prostate for Benign Prostatic Hypertrophy Oct 26, 2023 Oct 20, 2024 Benign prostatic hyperplasia (bph) is a common, noncancerous, and benign enlargement of the prostate gland.... Ver
07.001.172 Suture Button Suspensionplasty Fixation System for Thumb Carpometacarpal Osteoarthritis Nov 15, 2023 Nov 20, 2024 Suture button suspensionplasty for thumb carpometacarpal joint osteoarthritis is considered... Ver
07.001.173 Fractional Carbon Dioxide (CO2) Laser Ablation Treatment of Hypertrophic Scars or Keloids for Functional Improvement Feb 07, 2024 Feb 20, 2025 Carbon dioxide (co2) fractional laser ablation treatment of hypertrophic scars or keloids for functional... Ver
07.001.174 Peripheral Nerve Injury Repair Using Synthetic Conduits or Processed Nerve Allografts Feb 12, 2024 Feb 20, 2024 The use of processed nerve allograft for the repair and closure of peripheral nerve gaps is considered... Ver
07.002.001 Intravenous Sedation Sep 11, 2019 Policy Archived Triple-s salud does not routinely recognize separate sedation payment for endoscopic procedures. these... Ver
07.002.002 Monitored Anesthesia Care Dec 04, 2023 Dec 20, 2024 The use of monitored anesthesia care may be considered medically necessary for gastrointestinal endoscopy,... Ver
07.003.002 Placental and Umbilical Cord Blood as a Source of Stem Cells Mar 19, 2021 Policy Archived Transplantation of cord blood stem cells from related or unrelated donors may be considered medically... Ver
07.003.003 Isolated Small Bowel Transplant Sep 12, 2023 Sep 20, 2024 A small bowel transplant using cadaveric intestine may be considered medically necessary in adult and... Ver

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