Medical Policies - Univera Providers


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Showing 1– 25 of 292 Results
Title Last Updated Category
Coverage for Ambulatory Surgery Unit (ASU) and Anesthesia for Dental Surgery Open a PDF 7.03.01 2019-01-18 Anesthesiology
Ketamine for the Treatment of Psychiatric Disorders Open a PDF 3.01.13 2019-02-06 Behavioral Health (Psychology)
Applied Behavioral Analysis for Treatment of Autism Spectrum Disorders (ABA), Pervasive Developmental Disorders (PDD) Open a PDF 3.01.11 2019-01-18 Behavioral Health (Psychology)
Auditory Processing Disorder (APD) Testing Open a PDF 2.01.39 2019-01-18 Ear, Nose & Throat (Otorhinolaryngology)
Group Therapy for Mental Health Policy Open a PDF 3.01.08 2019-01-18 Behavioral Health (Psychology)
Sex Specific Services, Gender dysphoria, Gender Identity Disorder, GID, transgender, transsexualism Open a PDF 11.01.26 2019-01-18 Behavioral Health (Psychology)
Transcranial Magnetic Stimulation: Deep TMS device, MagVita TMS, NeuroStar TMS device, rTMS, TMS Open a PDF 3.01.09 2019-01-18 Behavioral Health (Psychology)
Phototherapy/Light Therapy for Seasonal Affective Disorder (SAD) Open a PDF 1.01.24 2018-11-26 Behavioral Health (Psychology)
Psychological Testing Open a PDF 3.01.02 2019-01-18 Behavioral Health (Psychology)
Chelation Therapy (e.g., EDTA, Endrate, Desferal, BAL in oil, Cuprimine, Depen, Zinecard, Exjade, Post-chelator Challenge Urinary Metal Testing. Post-provocation Urinary Metal Testing) Open a PDF 8.01.03 2018-11-19 Blood Disorders (Hematology)
Plasmapheresis, Plasma Exchange and Apheresis, Rheopheresis Open a PDF 8.01.04 2019-03-26 Blood Disorders (Hematology)
Electrothermal Collagen Shrinkage for Orthopedic Conditions, Thermal Capsulorrhaphy Open a PDF 7.01.46 2018-11-19 Bone & Joints (Orthopedic)
Manipulation Under Anesthesia (MUA), Manipulation under Joint Anesthesia (MUJA), Manipulation Under Sedation (MUS) Open a PDF 7.01.76 2019-01-15 Bone & Joints (Orthopedic)
Computerized Motion Diagnostic Imaging (CMDI), Gait Analysis Open a PDF 2.01.13 2019-02-06 Bone & Joints (Orthopedic)
Temporomandibular Joint (TMJ) Disease Open a PDF 11.01.17 2019-01-18 Bone & Joints (Orthopedic)
Prolotherapy (e.g., Sarapin) Open a PDF 8.01.10 2019-01-15 Bone & Joints (Orthopedic)
Shoulder Arthroplasty Open a PDF 7.01.95 2019-03-26 Bone & Joints (Orthopedic)
Photodynamic Therapy (PDT) for Malignant Disease (Photofrin, Porfimer Sodium) Open a PDF 8.01.06 2019-03-26 Cancer Treatment (Oncology)
Early Intervention Services Open a PDF 10.01.09 2018-11-26 Children's Health (Pediatrics)
Cranial Orthotics/Helmet for Asymmetry (e.g., Dynamic Orthotic Cranioplasty, DOC) Open a PDF 1.01.32 2019-01-18 Children's Health (Pediatrics)
Alopecia (e.g., Areata, Androgenic, Scarring), Baldness, Hair Loss Open a PDF 2.01.36 2019-01-18 Cosmetic / Reconstructive Surgery
Treatment of Hirsutism/ Hypertrichosis (Hair Removal) (e.g., Electrolysis, Epilation) Open a PDF 2.01.38 2019-01-18 Cosmetic / Reconstructive Surgery
Fecal Incontinence, Radiofrequency Treatment (Secca procedure) Open a PDF 7.01.66 2018-11-19 Digestive System (Gastroenterology)
Magnetic Esophageal Ring for the Treatment of Gastroesophageal Reflux (GERD): Esophageal Sphincter Device, LINX™ System, Magnetic Sphincter Augmentation Open a PDF 7.01.89 2019-03-26 Digestive System (Gastroenterology)
Gastric Electrical Stimulation and Gastric Pacing Open a PDF 7.01.64 2019-02-06 Digestive System (Gastroenterology)
Showing 1– 25 of 292 Results

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