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 |
|---|---|---|---|---|---|
| 07.001.163 | 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 | Jan 09, 2024 | Jun 20, 2024 | 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 |
| 07.003.005 | Allogeneic Pancreas Transplant | Sep 08, 2023 | Sep 20, 2024 | 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 12, 2023 | Sep 20, 2024 | A liver transplant using a cadaver or living donor may be considered medically necessary for carefully... | Ver |
| 07.003.007 | Heart Transplant | Sep 11, 2023 | Sep 20, 2024 | Human heart transplantation may be considered medically necessary for select adults and children with... | Ver |
| 07.003.008 | Lung and Lobar Lung Transplant | Sep 12, 2023 | Sep 20, 2024 | Lung transplantation may be considered medically necessary for carefully selected patients with irreversible,... | Ver |
