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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 |
|---|---|---|---|---|---|
| 07.001.169 | Temporarily Implanted Nitinol Device (iTind) for Benign Prostatic Hyperplasia | Jan 08, 2025 | Jan 20, 2026 | 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 24, 2024 | Oct 20, 2025 | Intraductal shockwave lithotripsy (iswl) may be considered medically necessary as a combination approach in... | Ver |
| 07.001.171 | Laser Surgery of the Prostate for Benign Prostatic Hypertrophy | Oct 24, 2024 | Oct 20, 2025 | 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 14, 2024 | Nov 20, 2025 | 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 04, 2025 | Feb 20, 2026 | 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, 2025 | Peripheral nerve injuries are common traumatic events for which the conventional treatment is the... | Ver |
| 07.001.175 | Intramedullary Limb-Lengthening System | Oct 24, 2024 | Oct 20, 2025 | Intramedullary limb-lengthening systems with the purpose of bone-lengthening are considered medically... | Ver |
| 07.001.176 | Irreversible Electroporation of Tumors Located in the Liver, Pancreas, Kidney, or Lung | Dec 17, 2024 | Dec 20, 2025 | Irreversible electroporation is considered investigational for treatment of primary or metastatic solid... | 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 13, 2024 | Dec 20, 2025 | The use of monitored anesthesia care may be considered medically necessary for gastrointestinal endoscopy,... | Ver |
| 07.002.003 | Percutaneous Revascularization Procedures for Lower Extremity Peripheral Arterial Disease | Nov 07, 2024 | Nov 20, 2025 | Percutaneous revascularization using balloon angioplasty, stent procedures, or atherectomy in individuals... | 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 18, 2024 | Sep 20, 2025 | A small bowel transplant using cadaveric intestine may be considered medically necessary in adult and... | Ver |
| 07.003.005 | Allogeneic Pancreas Transplant | Sep 23, 2024 | Sep 20, 2025 | Pancreas transplant after a prior kidney transplant may be considered medically necessary in patients with... | Ver |
| 07.003.006 | Liver Transplant and Combined Liver-Kidney Transplant | Sep 20, 2024 | Sep 20, 2025 | A liver transplant using a cadaver or living donor may be considered medically necessary for carefully... | Ver |
| 07.003.007 | Heart Transplant | Sep 23, 2024 | Sep 20, 2025 | Human heart transplantation may be considered medically necessary for select adults and children with... | Ver |
| 07.003.008 | Lung and Lobar Lung Transplant | Sep 20, 2024 | Sep 20, 2025 | A lung transplant consists of replacing all or part of diseased lungs with healthy lung(s) or lobes.... | Ver |
| 07.003.009 | Heart/Lung Transplant | Sep 20, 2024 | Sep 20, 2025 | Heart/lung transplantation may be considered medically necessary for carefully selected patients with... | Ver |
| 07.003.010 | Small Bowel/Liver and Multivisceral Transplant | Sep 18, 2024 | Sep 20, 2025 | Transplants, such as a multivisceral transplant and a small bowel and liver transplant, may be... | Ver |
| 07.003.011 | Islet Transplantation for Chronic Pancreatitis and Donislecel-jujn for Type 1 Diabetes | Oct 23, 2024 | Oct 20, 2025 | Autologous pancreas islet transplantation may be considered medically necessary as an adjunct to a total or... | Ver |
