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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 |
|---|---|---|---|---|---|
| 08.001.009 | Low-Level Laser Therapy | Jul 19, 2024 | Jul 20, 2025 | Low-level laser therapy may be considered medically necessary for prevention of oral mucositis in patients... | Ver |
| 08.001.010 | High-Dose Rate Temporary Prostate Brachytherapy | Aug 14, 2023 | Aug 20, 2024 | High-dose rate prostate brachytherapy may be considered medically necessary as monotherapy or in... | Ver |
| 08.001.011 | Manipulation Under Anesthesia | May 20, 2024 | May 20, 2025 | Spinal manipulation and manipulation of other joints performed during the procedure (eg, hip joint) with the... | Ver |
| 08.001.012 | Charged-Particle (Proton or Helium Ion) Radiotherapy for Neoplastic Conditions | Jun 10, 2024 | Jun 20, 2025 | Charged-particle irradiation with proton or helium ion beams may be considered medically necessary for... | Ver |
| 08.001.013 | Interferon Therapy | Jun 06, 2022 | Policy Archived | The use of recombinant or natural interferon alfa for the treatment of hematologic malignancies (lymphomas,... | Ver |
| 08.001.014 | Chelation Therapy for Off-Label Uses | Mar 19, 2024 | Mar 20, 2025 | Off-label applications of chelation therapy (see policy guidelines section for uses approved by the u.s. food... | Ver |
| 08.001.015 | Inhaled Nitric Oxide | Jun 11, 2024 | Jun 20, 2025 | Inhaled nitric oxide may be considered medically necessary as a component of treatment of: hypoxic... | Ver |
| 08.001.016 | Extracorporeal Photopheresis | Nov 15, 2023 | Nov 20, 2024 | Organ rejection after solid organ transplant extracorporeal photopheresis may be considered medically... | Ver |
| 08.001.017 | Accelerated Breast Irradiation and Brachytherapy Boost After Breast-Conserving Surgery for Early-Stage Breast Cancer | Aug 16, 2023 | Aug 20, 2024 | When using radiotherapy after breast-conserving surgery for early-stage breast cancer: accelerated... | Ver |
| 08.001.019 | Measurement of Exhaled Nitric Oxide and Exhaled Breath Condensate in the Diagnosis and Management of Respiratory Disorders | Jul 16, 2024 | Jul 20, 2025 | Measurement of exhaled nitric oxide is considered investigational in the diagnosis and management of... | Ver |
| 08.001.020 | Neutron Beam Radiotherapy | May 10, 2019 | Policy Archived | Neutron beam radiotherapy of advanced salivary gland tumors and soft tissue sarcomas is considered medically... | Ver |
| 08.001.021 | Scintimammography and Gamma Imaging of the Breast and Axilla | Oct 19, 2023 | Oct 20, 2024 | Scintimammography, breast-specific gamma imaging, and molecular breast imaging are... | Ver |
| 08.001.022 | Intracavitary Balloon Catheter Brain Brachytherapy for Malignant Gliomas or Metastasis to the Brain | Aug 09, 2023 | Aug 20, 2024 | Intracavitary balloon catheter brain brachytherapy is considered investigational,alone or as part of a... | Ver |
| 08.001.023 | ERWINAZE | Nov 10, 2021 | Policy Archived | Erwinaze is considered for payment in the treatment of acute lymphocytic leukemia and acute myeloid leukemia... | Ver |
| 08.001.024 | CORRECCION DE LOS TRASTORNOS DE LA REFRACCION | May 22, 2017 | Policy Archived | Corrección de trastornos de la visión no proceden para pago irrespectivo de la técnica o modalidad... | Ver |
| 08.001.025 | Adoptive Immunotherapy | Nov 13, 2023 | Nov 20, 2024 | All adoptive immunotherapy techniques intended to enhance autoimmune effects are... | Ver |
| 08.001.027 | Cellular Immunotherapy for Prostate Cancer | Aug 15, 2023 | Aug 20, 2024 | Sipuleucel-t therapy may be considered medically necessary in the treatment of asymptomatic or minimally... | Ver |
| 08.001.028 | Lysis of Epidural Adhesions | Dec 29, 2020 | Dec 29, 2021 | Catheter-based techniques for lysis of epidural adhesions, with or without endoscopic guidance, are... | Ver |
| 08.001.029 | Pneumatic Compression Pumps for Treatment of Lymphedema and Venous Ulcers | Apr 09, 2024 | Apr 20, 2025 | Single-compartment or multichamber nonprogrammable lymphedema pumps applied to the limb may be... | Ver |
| 08.001.030 | OCCUPATIONAL THERAPY | Jan 29, 2020 | Policy Archived | Occupational therapy services are considered for payment when they are performed to address the need of a... | Ver |
