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 |
|---|---|---|---|---|---|
| 02.003.003 | Policy Num: 02.003.003 | Feb 12, 2024 | Feb 20, 2024 | Single autologous hematopoietic cell transplantation (hct) may be considered medically necessary as salvage... | Ver |
| 02.003.004 | Hematopoietic Cell Transplantation for Central Nervous System Embryonal Tumors and Ependymoma | Feb 20, 2024 | Feb 20, 2025 | Embryonal tumors of the central nervous system autologous hematopoietic cell transplantation autologous... | Ver |
| 02.003.006 | Hematopoietic Cell Transplantation for Miscellaneous Solid Tumors in Adults | Feb 07, 2024 | Feb 20, 2025 | Autologous or allogeneic hematopoietic cell transplant is considered investigational for the following... | Ver |
| 02.003.007 | Hematopoietic Cell Transplantation for Solid Tumors of Childhood | Feb 12, 2024 | Feb 20, 2025 | Autologous hematopoietic cell transplantation may be considered medically necessary for: initial... | Ver |
| 02.003.008 | Transcatheter Arterial Chemoembolization to Treat Primary or Metastatic Liver Malignancies | Aug 11, 2023 | Aug 20, 2024 | Transcatheter arterial chemoembolization of the liver may be considered medically necessary: to treat... | Ver |
| 02.003.009 | TERMOTERAPIA DE MICROONDA PARA CANCER DE MAMA | Nov 16, 2017 | Policy Archived | Tratamiento no se considera para pago, ya que no ha sido aprobado por... | Ver |
| 02.003.013 | Allogeneic Hematopoietic Cell Transplantation for Genetic Diseases and Acquired Anemias | Mar 05, 2021 | Policy Archived | Allogeneic hematopoietic cell transplantation is considered medically necessary for select patients with... | Ver |
| 02.003.014 | Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms | Feb 20, 2024 | Feb 20, 2025 | Myeloablative allogeneic hematopoietic cell transplantation (allo-hct) may be considered medically... | Ver |
| 02.003.015 | RASTREO DEL TUMOR DURANTE LA RADIOTERAPIA | Oct 28, 2016 | Policy Archived | El rastreo intrafraccionario en tiempo real para ajustar dosis o para el monitoreo del movimiento de la... | Ver |
| 02.003.016 | INFUSIÓN DE LEUCOCITOS ALOGENEICOS PARA MALIGNIDADES HEMATOLÓGICAS QUE RECURREN DESPUÉS DE UN TRASPLANTE DE CÉLULAS ALOGENEICAS | Jun 20, 2011 | Oct 16, 2017 | Donantes de infusión de linfocitos procede para pago después de trasplante-alogeneico hematopoyético de... | Ver |
| 02.003.019 | Hyperthermic Intraperitoneal Chemotherapy for Select Intra-Abdominal and Pelvic Malignancies | Aug 09, 2023 | Aug 20, 2024 | Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (hipec) at the time of surgery may be... | Ver |
| 02.003.020 | AxIllary Reverse Mapping for Prevention of Breast Cancer-Related Lymphedema | Dec 12, 2023 | Dec 20, 2024 | Axillary reverse mapping/reverse lymphatic mapping performed during sentinel lymph node biopsy to prevent... | Ver |
| 02.004.001 | Esophageal pH Monitoring | Dec 12, 2023 | Dec 20, 2024 | Esophageal ph monitoring using a catheter or wireless-based system may be considered medically... | Ver |
| 02.004.002 | Wireless Capsule Endoscopy for Gastrointestinal (GI) Disorders | Jan 03, 2024 | Jan 20, 2025 | Wireless capsule endoscopy of the small bowel may be considered medically necessary for the following... | Ver |
| 02.004.005 | Transesophageal Endoscopic Therapies for Gastroesophageal Reflux Disease | Jan 03, 2024 | Jan 20, 2025 | Transoral incisionless fundoplication (ie, esophyx) is considered investigational as a treatment of... | Ver |
| 02.004.006 | Transanal Radiofrequency Treatment of Fecal Incontinence | Dec 09, 2021 | Policy Archived | Transanal radiofrequency therapy is considered investigational as a treatment of fecal... | Ver |
| 02.004.007 | ALISIS POR FIBRA OPTICA DE POLIPOS COLORECTALES | May 16, 2016 | Policy Archived | El análisis de pólipos colorectales por medio de fibra óptica no se considera para pago. el significado... | Ver |
| 02.004.048 | Nerve Fiber Density Measurement | Jan 19, 2024 | Jan 20, 2025 | Skin biopsy with epidermal nerve fiber density measurement for the diagnosis of small fiber neuropathy... | Ver |
| 02.004.049 | Percutaneous Electrical Nerve Field Stimulation for Irritable Bowel Syndrome | Jun 05, 2023 | Jun 20, 2024 | Percutaneous electrical nerve field stimulation for abdominal pain in individuals with irritable bowel... | Ver |
| 02.005.001 | Pulmonary Function Test | Nov 04, 2022 | Policy Archived | The following specific tests for evaluating pulmonary diseases are considered for payment: pulmonary... | Ver |
