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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 |
|---|---|---|---|---|---|
| 08.001.052 | Intraoperative Radiotherapy | Aug 09, 2023 | Aug 20, 2024 | Use of intraoperative radiotherapy may be considered medically necessary in the following situation:... | Ver |
| 08.001.053 | Chimeric Antigen Receptor Therapy for Leukemia and Lymphoma | Jan 08, 2024 | Jan 20, 2025 | Tisagenlecleucel for b-cell acute lymphoblastic leukemia tisagenlecleucel is considered medically... | Ver |
| 08.001.054 | Hematopoietic Cell Transplantation for Waldenstrom Macroglobulinemia | Mar 19, 2021 | Policy Archived | Autologous hematopoietic cell transplantation may be considered medically necessary as salvage therapy of... | Ver |
| 08.001.056 | Intradialytic Parenteral Nutrition | Jun 12, 2024 | Jun 20, 2025 | Intradialytic parenteral nutrition as an adjunct to hemodialysis may be considered medically necessary when... | Ver |
| 08.001.057 | Baroreflex Stimulation Devices | Jun 18, 2024 | Jun 20, 2025 | Use of baroreflex stimulation implanted devices is considered investigational in all situations, including... | Ver |
| 08.001.059 | Focal Treatments for Prostate Cancer | Oct 19, 2023 | Oct 20, 2024 | Use of any focal therapy modality to treat individuals with localized prostate cancer... | Ver |
| 08.001.060 | Dry Hydrotherapy for Chronic Pain Conditions | Jul 16, 2024 | Dec 20, 2024 | The use of dry hydrotherapy massagers for the treatment of chronic pain conditions is... | Ver |
| 08.001.061 | Stationary Ultrasonic Diathermy Devices | Feb 12, 2024 | Feb 20, 2025 | Ultrasonic diathermy devices for the treatment of musculoskeletal pain are considered... | Ver |
| 08.002.001 | Lipid Apheresis | Jul 29, 2021 | Policy Archived | Low-density lipoprotein (ldl) apheresis may be considered medically necessary in patients with homozygous... | Ver |
| 08.003.001 | Treatment of Tinnitus | Mar 19, 2024 | Mar 20, 2025 | Psychological coping therapy including cognitive-behavioral therapy, self-help cognitive-behavioral therapy,... | Ver |
| 08.003.002 | Outpatient Pulmonary Rehabilitation | Apr 08, 2024 | Apr 20, 2025 | A single course of pulmonary rehabilitation in the outpatient ambulatory care setting may be... | Ver |
| 08.003.003 | Cognitive Rehabilitation | Nov 09, 2022 | Policy Archived | Cognitive rehabilitation (as a distinct and definable component of the rehabilitation process) may be... | Ver |
| 08.003.004 | Sensory Integration Therapy and Auditory Therapy | Apr 15, 2024 | Oct 20, 2024 | Sensory integration therapy and auditory integration therapy are considered investigational except for the... | Ver |
| 08.003.005 | Endobronchial Brachytherapy | Aug 15, 2023 | Aug 20, 2024 | Endobronchial brachytherapy may be considered medically necessary in the following clinical situations:... | Ver |
| 08.003.006 | Cardiac Rehabilitation in the Outpatient Setting | Apr 09, 2024 | Apr 20, 2025 | Outpatient cardiac rehabilitation programs may be considered medically necessary for individuals with a... | Ver |
| 08.003.012 | Hippotherapy | May 20, 2024 | Policy Archived | Hippotherapy is considered investigational.... | Ver |
| 08.003.013 | Functional Neuromuscular Electrical Stimulation | Apr 08, 2024 | Apr 20, 2025 | Neuromuscular stimulation is considered investigational as a technique to restore function following nerve... | Ver |
| 09.001.001 | CONSULTAS | Aug 22, 2017 | Policy Archived | El médico consultor puede iniciar servicios diagnósticos y/o terapéuticos. la necesidad de consulta por... | Ver |
| 09.001.002 | Hospice Services at Home | Nov 11, 2020 | Policy Archived | Hospice services are considered for payment if they meet the following criteria: 1. physician... | Ver |
| 09.001.004 | Endothelial Keratoplasty | Apr 17, 2024 | Apr 20, 2025 | Endothelial keratoplasty (descemet stripping endothelial keratoplasty, descemet stripping automated... | Ver |
