Medical Policies - Univera Providers

Breadcrumb

Page Title for page template

Medical Policies

Nested Applications

Medical Policies - Main Content

In accessing our Medical Policies you signify your agreement to our Terms of Use.

Learn more about how Medical Policies are developedOpen a PDF and about Experimental & Investigational Procedures.

Medical Policies - Right Column Box

Make a Comment

We invite practitioners to review & comment on our policies

Asset Search Filter and Browse

or
Showing 51– 75 of 292 Results
Title Last Updated Category
Chromosomal Microarray Analysis for Prenatal Evaluation and for the Evaluation of Patients with Developmental Delay Open a PDF 2.02.42 2019-01-18 Genetic Disease (Inherited Disease)
Circulating Tumor DNA for Management of Cancer (Liquid Biopsy) Open a PDF 7.01.102 2019-09-19 Lab Tests (pathology)
Clinical Trials Open a PDF 11.01.10 2019-01-18 Miscellaneous
Cochlear Implants and Auditory Brainstem Implants: Advanced Bionics® HiResolution Bionic Ear System (HiRes 90k), Cochlear® Nucleus 5, Med El® Maestro (Sonata or Pulsar), Nucleus 24® Auditory Brainstem Implant System, Nucleus® Hybrid™ L24 Cochlear Implant Open a PDF 7.01.26 2019-06-14 Ear, Nose & Throat (Otorhinolaryngology)
Cognitive Rehabilitation, Attention Rehabilitation, Sensory Integration Therapy Open a PDF 8.01.19 2019-08-12 Therapy & Rehabilitation
Collagenase Clostridium Histolyticum (Xiaflex) for Fibroproliferative Disorders Open a PDF 5.01.15 2019-04-30 Drug / Medications
Colorectal Cancer Screening, Cologuard, CT Colonography, FIT, gFOBT, virtual colonoscopy, fecal DNA, fecal occult blood test Open a PDF 2.01.51 2019-09-24 Digestive System (Gastroenterology)
Comfort, Convenience, Custodial or Cosmetic Services Open a PDF 11.01.11 2019-06-04 Miscellaneous
Computerized Motion Diagnostic Imaging (CMDI), Gait Analysis Open a PDF 2.01.13 2019-02-06 Bone & Joints (Orthopedic)
Continuous Passive Motion Device (CPM) in the Home Setting Open a PDF 1.01.02 2019-09-27 Durable Medical Equipment & Supplies
Corneal Ultrasound Pachymetry Open a PDF 9.01.07 2019-06-04 Eyes (Ophthalmology)
Coronary Calcium Scoring : Electron Beam CT (EBCT), Helical CT, Spiral CT, Multidetector Row CT (MDCT), Ultrafast CT, Cardiac Calcium Scoring Open a PDF 6.01.13 2019-03-26 Radiology (x-rays) & Imaging
Cosmetic and Reconstructive Procedures: Acne Cysts, Actinic Keratoses, Collagen Injection, Complexion Analysis, Dermatoscopy, Drionic, Face Lift, Hairplasty, Hair Transplant, Hyperhydrosis, Iontophoresis, Labiaplasty, Liposuction, Prolaryn,Tattoos, Voice Lift, Benign Skin Lesion Removal, Skin Tag Removal, Keloid Scars, Chemical Peel, Dermabrasion, Port Wine Stains, Rosacea, Vitiligo Open a PDF 7.01.11 2019-06-04 Cosmetic / Reconstructive Surgery
Coverage for Ambulatory Surgery Unit (ASU) and Anesthesia for Dental Surgery Open a PDF 7.03.01 2019-01-18 Anesthesiology
Coverage for Dependents with Disabilities Open a PDF 10.01.08 2019-08-12 Miscellaneous
Cranial Orthotics/Helmet for Asymmetry (e.g., Dynamic Orthotic Cranioplasty, DOC) Open a PDF 1.01.32 2019-01-18 Children's Health (Pediatrics)
Cryosurgery for Prostate Cancer Open a PDF 7.01.01 2019-08-22 Urinary System (Genitourinary)
Cryosurgical Tumor Ablation Open a PDF 7.01.03 2019-06-04 Cancer Treatment (Oncology)
Cryotherapy, Cold Therapy, Ice Therapy Open a PDF 1.01.21 2019-08-12 Bone & Joints (Orthopedic)
CT (Computed Tomography) Perfusion Imaging - Dynamic Perfusion CT, Multimodal CT, Perfusion CT, Xenon-enhanced CT (XeCT) Open a PDF 6.01.37 2018-04-04 Radiology (x-rays) & Imaging
Deep Brain Stimulation Open a PDF 7.01.23 2019-04-30 Nervous Systems (Neurology)
Dental and Oral Care under Medical Plans: Bone Cysts, Odontogenic Cysts, Oral Surgery Open a PDF 7.01.21 2019-08-12 Dental
Dental Crowns and Veneers Open a PDF 13.01.02 2019-08-12 Dental
Dental Implants Open a PDF 13.01.01 2019-08-12 Dental
Dental Inlays and Onlays Open a PDF 13.01.03 2019-08-12 Dental
Showing 51– 75 of 292 Results

GLO-PRV-Medical Policies - Terms of Use Modal

Modal for Medical Policy Terms of Use