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

Showing 76– 100 of 294 Results
Title Last Updated Category
Dental Inlays and Onlays Open a PDF 13.01.03 2020-07-17 Dental
Developmental Evaluation and Testing Open a PDF 2.01.54 2020-02-21 Children's Health (Pediatrics)
Disability Determination for Extension of Benefits after Contract Termination Open a PDF 10.01.11 2019-09-27 Miscellaneous
Drug-Eluting Sinus Stents for Postoperative Use Following Endoscopic Sinus Surgery Open a PDF 7.01.99 2020-05-26 Ear, Nose & Throat (Otorhinolaryngology)
Durable Medical Equipment (DME) - Standard and Non-Standard, Home Medical Equipment Open a PDF 1.01.00 2019-09-27 Durable Medical Equipment & Supplies
Dynamic Adjustable Braces/Joint Extension Device (e.g., Dynasplint™, EMPI Advance™, LMB Proglide™, Ultraflex™ Open a PDF 1.01.35 2020-03-27 Bone & Joints (Orthopedic)
Early Intervention Services Open a PDF 10.01.09 2018-11-26 Children's Health (Pediatrics)
Electrical Stimulation: Transcutaneous Electrical Nerve (TENS), Percutaneous Electrical Nerve (PENS), H-Wave and Interferential Stimulators (IFS), Percutaneous Neuromodulation Therapy, Bionicare® Open a PDF 1.01.01 2020-07-17 Durable Medical Equipment & Supplies
Electromagnetic Navigation Bronchoscopy (ENB) Open a PDF 6.01.40 2020-02-26 Lungs (Respiratory)
Emergency Care Services Open a PDF 10.01.12 2020-05-13 Miscellaneous
End-Diastolic Pneumatic Compression (e.g., Circulator) Boot Open a PDF 1.01.31 2020-05-08 Heart & Blood Vessels (Cardiovascular)
Endometrial Ablation: Her Option™, Hydro ThermAblator®, MEA System, Novasure™, Resectoscope, Rollerball, ThermaChoice®, Thermal Balloon Therapy Open a PDF 4.01.01 2020-03-18 Women's Health (Obstetrics & Gynecology)
Endovascular Repair (Coil Embolization) of Intracranial Aneurysms - Enterprise Stent, Guglielmi Coil, Neuroform Stent, Pipeline Embolization Device (PEI), Transcatheter Intracranial Embolization Open a PDF 7.01.81 2020-05-08 Nervous Systems (Neurology)
Enteral Formula/Nutrition, Enteral Therapy, Probiotics, Tube Feeding Open a PDF 10.01.03 2020-03-27 Food (Nutrition)
Erectile Dysfunction: Caverject, Edex, ErecAid, Intracavernosal Therapy, Intraurethral Therapy, MUSE (Medicated Urethral System for Erection), Penile Prosthesis, Penile Vein Ligation, Vacuum Erection Device, Vascular Revascularization Open a PDF 7.01.30 2019-09-27 Urinary System (Genitourinary)
Evoked Potentials: Auditory, Brainstem Auditory, Somatosensory, Visual and Intraoperative Monitoring of Evoked Potentials Open a PDF 2.01.27 2020-04-15 Nervous Systems (Neurology)
Experimental or Investigational Services Open a PDF 11.01.03 2020-03-27 Miscellaneous
External Prosthetic Devices: C-leg, Intelligent prosthesis, microprocessor-controlled lower limbs, Ossur Rheo, Vacuum-assisted-socket system (VASS) Open a PDF 1.01.18 2020-03-27 Miscellaneous
Extracorporeal Photochemotherapy/Photopheresis Open a PDF 8.01.01 2020-01-16 Skin (Dermatology)
Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions and Soft Tissue Wounds: Lithotripsy, Orthotripsy, OssaTron®, EpoUltra®, SINOCUR®, Orbasone™, Orthospec™ Open a PDF 2.01.31 2020-04-15 Bone & Joints (Orthopedic)
Extracranial Carotid and Vertebral Artery Angioplasty and Stents (e.g., Percutaneous Transluminal Angioplasty, PTA) Open a PDF 7.01.60 2020-04-15 Heart & Blood Vessels (Cardiovascular)
Fecal Bacteriotherapy, Fecal microbiota therapy (FMT), Fecal transfusion, Fecal transplant, Human probiotic infusion (HPI), Intestinal Microbiotia Transplantation (IMT), Microbiome, Stool transplant Open a PDF 2.01.48 2019-10-15 Digestive System (Gastroenterology)
Fecal Incontinence, Radiofrequency Treatment (Secca procedure) Open a PDF 7.01.66 2019-11-12 Digestive System (Gastroenterology)
Female Sterilization (e.g., Adiana®, Essure®, Tubal Ligation) Open a PDF 4.01.07 2019-11-25 Women's Health (Obstetrics & Gynecology)
First Trimester Screening for Down Syndrome (e.g., Cell-Free Fetal DNA, Harmony™, Free Beta PAPP-A, MaterniT21™, Non-invasive Prenatal Testing, Nuchal Translucency, Panorama™, Verify®) Open a PDF 2.02.25 2020-04-15 Lab Tests (pathology)
Showing 76– 100 of 294 Results

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