Categorical Medical Policies
Categorical Medical Policies
Our current medical policies are listed by category below.
Administrative | Durable Medical Equipment (DME) | Laboratory | Medicine | Mental Health | OB/GYN Reproduction | Other | Pharmacology | Radiology | Surgery | Therapy
Administrative
- Accident Related Dental Services
- Anesthesia in Hospital Setting for Dental or Oral Surgery Procedures
- Consultations versus Referrals
- Co-surgeons and Team Surgeons
- Digital Electroencephalography (DEEG) Analysis
- Investigational Criteria
- Management of Hyperbilirubinemia in Newborns: Follow-Up Visits
- Medical Criteria for Physical/Occupational Therapy and Osteopathic/Chiropractic Manipulative Treatment
- Modifier 25
- Off-Label Drug Use
- Pediatric and Neonatal Critical Care Services and Intensive (Non-Critical) Care Services
- Preventive Care Services under Health Care Reform
- Reconstructive versus Cosmetic Surgery
- Repair of Durable Medical Equipment (DME) and External Prosthetic Devices
Durable Medical Equipment (DME)
- Actigraphy
- Adjustable Cranial Orthoses for Positional Plagiocephaly and Craniosynostoses
- Cardioverter Defibrillators: Wearable or External
- Continuous or Intermittent Monitoring of Glucose in the Interstitial Fluid
- Continuous Passive Motion Devices
- Electrical Bone Growth Stimulation: Electrical (Invasive, Semi-invasive and Noninvasive) of the Appendicular Skeleton
- Electrical Stimulation in the Treatment of Arthritis
- Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures
- External Ambulatory Insulin Infusion Pump
- Foot Orthotics
- Heating and Cooling Devices Used in the Home Setting
- Holter Monitoring (Ambulatory Electrocardiography)
- Home Apnea Monitoring
- Home Prothrombin Time Testing (INR Monitoring)
- Interferential Stimulator/Stimulation Devices
- Lasette, Laser Lancet
- Lower Limb Prostheses
- Lymphedema Pumps/Pneumatic Compression Devices
- Microprocessor-Controlled Lower Limb Prosthesis
- Myoelectric Prosthetic Components for the Upper Limb
- Negative Pressure Wound Treatment in the Outpatient Setting
- Noncontact Radiant Heat Bandage for the Treatment of Wounds
- Noninvasive Positive Pressure Ventilation
- Oscillatory Devices for Airway Clearance (The Vest, Intrapulmonary Percussive Ventilation (IPV), Flutter Device)
- Outpatient Use of Limb Pneumatic Compression Devices for Venous Thromboembolism Prophylaxis
- Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence
- Phototherapy for the Treatment of Skin Disorders
- Pressure Reducing Support Surfaces
- Pulsed Irrigation Evacuation (PIE)
- Stretching and Splinting Devices for the Treatment of Joint Stiffness and Contractures
- Thoracic-Lumbo-Sacral Orthosis with Pneumatics
- Threshold Electrical Stimulation as a Treatment of Motor Disorders
- Transcutaneous Electrical Nerve Stimulation (TENS)
- Transtympanic Micropressure Applications as a Treatment of Menieres Disease
- Tumor-Treating Fields Therapy for Glioblastoma
Laboratory
- Allergy Testing
- Analysis of Human DNA in Stool Samples as a Technique for Colorectal Cancer Screening
- Antigen Leukocyte Cellular Antibody Test (ALCAT)
- Antiprothrombin Antibody
- Apolipoprotein B in the Risk Assessment and Management of Cardiovascular Disease
- Apolipoprotein E Genotype or Phenotype in the Management of Cardiovascular Disease
- Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer
- BCR-ABL1 Testing in Chronic Myelogenous Leukemia and Acute Lymphoblastic Leukemia
- Biochemical Markers of Alzheimers Disease
- Bio-Engineered Skin and Soft Tissue Substitutes
- B-Natriuretic Peptide
- Bone Turnover Markers for the Diagnosis and Management of Osteoporosis
- BRAF Gene Mutation Testing To Select Melanoma Patients for BRAF Inhibitor Targeted Therapy
- Cardiovascular Risk Panels
- Combination of Serum Markers for Liver Fibrosis in the Evaluation and Monitoring of Patients with Chronic Liver Disease
- Cytochrome p450 Genotyping
- Detection of Circulating Tumor Cells in the Management of Patients with Cancer
- DNA-Based Testing for Adolescent Idiopathic Scoliosis
- End-Tidal Carbon Monoxide Measurement (ETCOc)
- Epidermal Growth Factor Receptor (EGFR) Mutation Analysis for Patients with Non-Small-Cell Lung Cancer (NSCLC)
- Facet Joint Injections, Trigger Point Injections, and Epidural Injections of Corticosteroids and/or Local Anesthetics
- Fecal Analysis in the Diagnosis of Intestinal Dysbiosis
- Fecal Calprotectin Testing
- Fetal Fibronectin Enzyme Immunoassay
- Gamma Interferon Blood Test for Diagnosis of Latent Tuberculosis
- Gene Expression Testing to Predict Coronary Artery Disease
- Gene-Based Tests for Screening, Detection, and/or Management of Prostate Cancer
- Genetic Cancer Susceptibility Panels Using Next Generation Sequencing
- Genetic Testing for Alpha-1 Antitrypsin Deficiency
- Genetic Testing for Familial Alzheimer
- Genetic Testing for Hereditary Breast and/or Ovarian Cancer
- Genetic Testing for Hereditary Hemochromatosis
- Genetic Testing for Inherited Cancer Predisposition and or Pharmacogenetics related to Cancer Treatment
- Genetic Testing for Lipoprotein(a) Variant(s) as a Decision Aid for Aspirin Treatment
- Genetic Testing for Mental Health Conditions
- Genetic Testing for Non-Cancerous Inheritable Diseases
- Genetic Testing for Warfarin Dose
- Genetic Testing, Including Chromosomal Microarray (CMA) Analysis and Next Generation Sequencing Panels, for the Genetic Evaluation of Patients with Developmental Delay/Intellectual Disability or Autism Spectrum Disorder
- Genotyping for 9p21 Single Nucleotide Polymorphisms to Predict Risk of Cardiovascular Disease or Aneurysm
- Heart Transplant Rejection Testing
- High Sensitivity C-Reactive Protein
- High-Density Lipoprotein Subclass Testing in the diagnosis and Management of Cardiovascular Disease
- HIV Genotyping and Phenotyping
- Homocysteine Testing in the Screening, Diagnosis, and Management of Cardiovascular Disease
- Human Leukocyte Antigen (HLA) Testing for Celiac Disease
- Immunoassay/Immunochemical Fecal Occult Blood Testing
- In Vitro Chemoresistance and Chemosensitivity Assays
- Intracellular Micronutrient Analysis
- JAK2 and MPL Mutation Analysis in Myeloproliferative Neoplasms
- KIF6 Genotyping for Predicting Cardiovascular Risk and/or Effectiveness of Statin Therapy
- KRAS Mutation Analysis in Non-Small-Cell Lung Cancer (NSCLC)
- Laboratory and Genetic Testing for Use of 5-Flourouracil (5-FU) in Patients with Cancer
- Laboratory Testing for HIV Tropism
- Laboratory Tests of Sperm Maturity, Function and DNA Integrity
- Lipoprotein-Associated Phospholipase A2: PLAC Test
- Magnetic Resonance Cholangiopancreatography (MRCP)
- Measurement of Long-Chain Omega-3 Fatty Acids in Red Blood Cell Membranes as a Cardiac Risk Factor
- Measurement of Serum Antibodies to Infliximab
- Measurement of Small Low Density Lipoprotein (LDL) Particles and Lipoprotein (a) [lp(a)] Enzyme Immunoassay in the Management of Cardiovascular Disease
- Microarray-Based Gene Expression Profile Testing for Multiple Myeloma Risk Stratification
- Microarray-Based Gene Expression Testing for Cancers of Unknown Primary
- Molecular Markers in Fine Needle Aspirates of the Thyroid
- Molecular Profiling for the Evaluation of Malignant Tumors
- PathFinderTG Molecular Testing
- Pharmacogenomic and Metabolite Markers for Patients Treated with Thiopurines
- Proteomics-Based Testing Related to Ovarian Cancer
- Routine Human Papillomavirus (HPV) Testing
- Serologic Diagnosis of Celiac Disease
- Serum Biomarker Human Epididymis Protein 4 (HE4)
- Serum Holotranscobalamin as a Marker of Vitamin B12 (Cobalamin) Status
- Systems Pathology for Predicting Risk of Recurrence in Prostate Cancer
- Urea Breath Test for Diagnosis of Helicobacter Pylori
- Use of Common Genetic Variants to Predict Risk of Nonfamilial Breast Cancer
- Whole Exome Sequencing
Medicine
- Acoustic Cardiography Correlated Audioelectric Cardiography
- Aerosolized Antibiotics as a Treatment of Chronic Sinusitis
- Allergy Immunotherapy
- Ambulatory Esophageal pH Monitoring
- Ambulatory Event Monitors
- Analysis of Proteomic Patterns in Serum to Identify Cancer
- Anti-CCP Testing for Rheumatoid Arthritis
- Antineoplaston Cancer Therapy
- Automated Ambulatory Blood Pressure Monitoring
- Automated Point-of-Care Nerve Conduction Tests
- Bioimpedance Devices for Detection of Lymphedema
- Biomarker Genes for Detection of Lymph Node Metastases in Breast Cancer
- Botulinum Toxin
- Cardiac Hemodynamic Monitoring for the Management of Heart Failure in the Outpatient Setting
- Cardiointegram (CIG) or Omnicardiogram
- Cardiopulmonary Exercise Stress Test (CPET/CPX)
- Catheter Ablation for Cardiac Arrhythmias
- Cellular Immunotherapy for Prostate Cancer
- Computerized 2-lead Resting Electrocardiogram Analysis for the Diagnosis of Coronary Artery Disease
- Computerized Pulse Waveform Analysis
- COPES Scoliosis Treatment Recovery System
- Corneal Hysteresis
- Corneal Pachymetry
- Dermal Fillers
- Diagnosis and Management of Idiopathic Environmental Intolerance (i.e., Multiple Chemical Sensitivities)
- Diagnosis and Treatment of Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis
- Diagnosis and Treatment of Sacroiliac Joint Pain
- Dynamic Posturography
- Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures
- Electrocardiographic Body Surface Mapping
- Electrostimulation and Electromagnetic Therapy for the Treatment of Chronic Wounds
- Enhanced External Counterpulsation (EECP)
- Evoked Potential Studies
- Extracorporeal Shock Wave Treatment for Plantar Fasciitis and Other Musculoskeletal Conditions
- Gait Analysis
- High Risk Maternity Care
- Identification of Microorganisms Using Nucleic Acid Probes
- Immune Cell Function Assay in Solid Organ Transplantation
- Ingestible pH and Pressure Capsule
- Intra-articular Hyaluronan Injections for Osteoarthritis
- Intracoronary Physiologic Measurements
- Intraoperative Neurophysiologic Monitoring
- Intravenous Anesthetics for the Treatment of Chronic Pain
- KRAS and BRAF Mutation Analysis in Metastatic Colorectal Cancer
- Laser Treatment of Onychomycosis
- Left-Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation
- Light Therapy for Psoriasis
- Magnetic Esophageal Ring to Treat Gastroesophageal Reflux Disease (GERD)
- Management of Hereditary Angioedema
- Management of Obstructive Sleep Apnea Syndrome
- Measurement of Exhaled Nitric Oxide and Exhaled Breath Condensate in the Diagnosis and Management of Asthma and Other Respiratory Disorders
- Microarray-Based Gene Expression Testing for Cancers of Unknown Primary
- Mobile Cardiac Outpatient Telemetry and Hybrid Devices
- Monitoring of Regional Cerebral Blood Flow Using an Implanted Cerebral Thermal Perfusion Probe
- Navigated Transcranial Magnetic Stimulation (nTMS)
- Nerve Fiber Density
- Neuromuscular and Electrodiagnostic Testing (EDX): Nerve Conduction Studies (NCS) and Electromyography (EMG) Studies
- Non-Contact Ultrasound Treatment for Wounds
- Non-Oncologic Uses of Rituximab (Rituxan)
- Nutritional Treatment of Childhood Medical Conditions
- Ophthalmologic Techniques for Evaluating Glaucoma
- Optical Diagnostic Devices for Evaluating Skin Lesions Suspected of Malignancy
- Oral Lesion Identification System (ViziLite™, Velscope™)
- Orthopedic Applications of Stem Cell Therapy
- Paraspinal Surface Electromyography (SEMG) to Evaluate and Monitor Back Pain
- Peripheral Subcutaneous Field Stimulation
- Photodynamic Therapy for Dermatological Applications
- Photodynamic Therapy, Ocular: Visudyne (Verteporfin)
- Phototherapy for the Treatment of Skin Disorders
- Placental/Umbilical Cord Blood as a Source of Stem Cells
- Polysomnography/Sleep Disorders Testing
- Quantitative Assay for Measurement of HER2 Total Protein Expression and HER2 Dimers
- Quantitative Sensory Testing (QST)
- Retinal Telescreening for Diabetic Retinopathy
- Routine Human Papillomavirus (HPV) Testing
- Sacroiliac Joint Fusion
- Serum Antibodies for the Diagnosis of Inflammatory Bowel Disease
- Serum Holotranscobalamin as a Marker of Vitamin B12 (Cobalamin) Status
- Serum Tumor Markers for Breast and Gastrointestinal Malignancies
- Signal-Averaged Electrocardiography
- Speculoscopy
- Systems Pathology for Predicting Risk of Recurrence in Prostate Cancer
- Temporary Prostatic Stent
- Transanal Radiofrequency Treatment of Fecal Incontinence
- Transcatheter Ablation of Arrhythmogenic Foci as a Treatment of Atrial Fibrillation
- Transcatheter Closure Devices for Patent Foramen Ovale (PFO) Defects
- Transcatheter Closure Devices for Septal Defects
- Transcatheter Closure of Septal Devices
- Transcranial Magnetic Stimulation as a Treatment of Depression and Other Psychiatric Disorders
- Transvaginal and Transurethral Radiofrequency Tissue Remodeling for Urinary Stress Incontinence
- Treatment of Tinnitus
- Ultrafiltration in Decompensated Heart Failure
- Ultrasonographic Measurement of Carotid Intimal-Medial Thickness as an Assessment of Subclinical Atherosclerosis
- Urea Breath Test for Diagnosis of Helicobacter Pylori
- Urinary Tumor Markers for Bladder Cancer
- Urodynamic Testing to Evaluate Urinary Incontinence
- Uses of Monoclonal Antibodies for the Treatment of Non-Hodgkin Lymphoma, including Chronic Lymphocytic Leukemia, and Acute Myeloid Leukemia in the Non-Hematopoietic Stem-Cell Transplant Setting
- Vestibular Autorotation Test (VAT)
Mental Health
OB/GYN Reproduction
- Biophysical Fetal Profile
- Fetal Echocardiography
- First-Trimester Detection of Down Syndrome Using Fetal Ultrasound Assessment of Nuchal Translucency Combined with Maternal Serum Assessment
- Injectable Progesterone Therapy as a Technique to Reduce Preterm Birth in High-Risk Pregnancies
- Levonorgestrel-releasing Intrauterine System (LNG-IUS) (Mirena®)
- Noninvasive Prenatal Testing for Trisomy 21 Using Cell Free Fetal DNA
- Speculoscopy
- Surgical Interruption of Pelvic Nerve Pathways for Primary and Secondary Dysmenorrhea
- Ultrasounds in Maternity Care
Other
- Anterior Eye Segment Imaging
- Bispectral Index Monitoring During General Anesthesia
- Conjunctival Incision with Posterior Juxtascleral Placement of Anecortave Acetate Depot Suspension
- Endothelial Keratoplasty
- Intraoperative Transesophageal Echocardiography
- Monitored Anesthesia Care (MAC)
- Nutritional Supplements for Phenylketonuria (PKU)
- Oral Lesion Identification System (ViziLite™, Velscope™)
- Recombinant and Autologous Platelet-Derived Growth Factors as a Treatment of Wound Healing and Other Conditions
- Suprachoroidal Delivery of Pharmacological Agents
- Transciliary Fistulization for the Treatment of Glaucoma
- Use of Anesthesia Services for Routine Gastrointestinal Endoscopy
Pharmacology
- Xiaflex (collagenase clostridium histolyticum) for Fibroproliferative Disorders
- Acute and Maintenance Tocolysis
- Adcetris (Brentuximab vedotin)
- Ado-Trastuzumab Emtansine (Trastuzumab-DM1) for Treatment of HER-2 Positive Malignancies
- AMEVIVE (Alefacept)
- Benlysta® (Belimumab)
- Bevacizumab, Avastin
- Boniva® (Ibandronate Sodium) Infusion
- Cetuximab, Erbitux®
- Colony Stimulating Factors (CSFs)
- Growth Hormone and Insulin-Like Growth Factor-1 (IGF-1) Analogues
- Immune Prophylaxis for Respiratory Syncytial Virus: Synagis® (Palivizumab)
- Implantable Hormone Replacement Pellets
- Intravenous Antibiotic Therapy and Associated Diagnostic Testing for Lyme Disease
- Kyprolis (Carfilzomib injection)
- Lucentis (Ranibizumab Injection)
- Mozobil (Plerixafor)
- Naltrexone (Vivitrol®) Injections
- Nulojix (Belatacept)
- Opioid Antagonists Under Heavy Sedation or General Anesthesia as a Technique of Opioid Detoxification
- Panitumumab, Vectibix
- Pegloticase (Krystexxa™)
- Pertuzumab (PERJETA)
- Qutenza® (capsaicin) 8% Patch
- Repository Corticotropin Injection
- TNF Antagonists and Other Biologics
- Trastuzumab
- Tysabri (natalizumab) for the Treatment of Multiple Sclerosis
- Xolair (Omalizumab)
- Yervoy (Ipilimumab)
- Zaltrap (ziv-aflibercept)
- Zoledronic Acid (Reclast®) Injection
Radiology
- Beta Amyloid Imaging with Positron Emission Tomography (PET) for Alzheimers disease
- Bone Mineral Density Testing
- Cardiac Computed Tomography (CCT), Cardiac Computed Tomography Angiography (CCTA)
- Charged-Particle (Proton or Helium Ion) Radiation Therapy
- Chromoendoscopy as an Adjunct to Colonoscopy
- Computed Tomography and Computed Tomographic Angiography of Extremity or Joint
- Computed Tomography and Computed Tomographic Angiography of the Abdomen and Pelvis
- Computed Tomography and Computed Tomographic Angiography of the Chest and Thorax
- Computed Tomography and Computed Tomographic Angiography of the Head and Neck
- Computed Tomography of Cervical, Thoracic, and Lumbar Spine
- Computed Tomography Perfusion Imaging
- Computed Tomography to Detect Coronary Artery Calcification
- Computer-aided Detection (CAD) Mammography
- Digital Breast Tomosynthesis
- Dopamine Transporter Imaging with Single Photon Emission Computed Tomography (DAT-SPECT)
- Dynamic Spinal Visualization
- Electromagnetic Navigational Bronchoscopy
- Endobronchial Brachytherapy
- Fetal Echocardiography
- Functional Magnetic Resonance Imaging (MRI)
- High-Dose Rate Temporary Prostate Brachytherapy
- Intensity-Modulated Radiation Therapy (IMRT)
- Intracavitary Balloon Catheter Brain Brachytherapy for Malignant Gliomas or Metastasis to the Brain
- Intraocular Radiation Therapy for Age-Related Macular Degeneration
- Intraoperative Radiation Therapy (IORT)
- Locoregional Therapies for Hepatocellular Carcinoma and Metastatic Liver Carcinoma and Metastatic Carcinoid Tumors of the Liver
- Lung Cancer Screening Using Computed Tomography (CT) or Chest Radiographs
- Magnetic Resonance Angiography (MRA) of the Chest (excluding the heart)
- Magnetic Resonance Angiography of Vessels of the Head, Neck, Abdomen, Pelvis, Spinal Canal, and Upper and Lower Extremity
- Magnetic Resonance Imaging (MRI) of Neck, Face, Orbit
- Magnetic Resonance Imaging (MRI) of the Abdomen and Pelvis
- Magnetic Resonance Imaging (MRI) of the Brain
- Magnetic Resonance Imaging (MRI) of the Breast
- Magnetic Resonance Imaging (MRI) of the Cervical, Thoracic, and Lumbar Spine
- Magnetic Resonance Imaging (MRI) of the Chest
- Magnetic Resonance Imaging (MRI) of the Extremities and Extremity Joints
- Magnetic Resonance Imaging (MRI) of the Heart
- Magnetic Resonance Imaging (MRI) of the Temporomandibular Joint (TMJ)
- Magnetic Resonance Imaging for Bone Marrow Blood Supply
- Magnetic Resonance Neurography
- Magnetic Resonance Spectroscopy
- Magnetoencephalography/Magnetic Source Imaging
- MRI Phase-Contrast Flow Measurement
- MRI-Guided Focused Ultrasound (MRgFUS)
- Myocardial Perfusion Imaging
- Myocardial Sympathetic Innervation Imaging in Patients with Heart Failure
- Oncologic Applications of Photodynamic Therapy, Including Barretts Esophagitis
- Optical Coherence Tomography (OCT) for Imaging of Coronary Arteries
- Percutaneous Vertebroplasty, Kyphoplasty, Mechanical Vertebral Augmentation and Sacroplasty
- Positron Emission Mammography (PEM)
- Positron Emission Tomography (PET)-Cardiac Applications
- Positron Emission Tomography (PET)-Miscellaneous Applications
- Positron Emission Tomography (PET)-Oncologic Applications
- Radioimmunoscintigraphy Imaging with Indium-111 Capromab Pendetide (ProstaScint®) for Prostate Cancer
- Real-Time Intra-Fraction Motion Management During Radiation Therapy
- Scintimammography and Gamma Imaging of the Breast and Axilla
- Standing Magnetic Resonance Imaging (MRI) (Vertical or Positional MRI)
- Stereotactic Radiosurgery
- Stress Echocardiography
- Thermography
- Three-D (3-D) Reconstruction for Computed Tomography, Magnetic Resonance Imaging, Ultrasound, or Other Tomographic Modalities
- Total Body CT Screening
- Ultrasonographic Evaluation of Skin Lesions
- Ultrasound of the Spinal Canal
- Vertebral Fracture Assessment with Dual X-Ray Absorptiometry (DEXA)
- Virtual Colonoscopy/CT Colonography
- Whole Body Dual X-Ray Absorptiometry (DEXA) to Determine Body Composition
- Wireless Capsule Endoscopy (Given Video Capsule)
- Xofigo (Radium Ra 223 Dichloride)
Surgery
- Ablation of Bone Tumors
- Adjustable Gastric Banding for Morbid Obesity
- Allogeneic Hematopoietic Stem-Cell Transplantation for Genetic Diseases and Acquired Anemias
- Allogeneic Pancreas Transplant
- Allogeneic Stem-Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms
- Aqueous Shunts and Stents for Glaucoma
- Arthroscopic Debridement and Lavage as Treatment for Osteoarthritis of the Knee
- Artificial Intervertebral Disc
- Auditory Brain Stem Implant
- Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions
- Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions
- Autologous Fat Grafting to the Breast and Adipose-derived Stem Cells
- Autologous Hematopoietic Stem-Cell Transplantation for Malignant Astrocytomas and Gliomas
- Automated Percutaneous and Endoscopic Discectomy
- Balloon Ostial Dilation for Treatment of Chronic Sinusitis
- Baroreflex Stimulation Devices
- Bi-Ventricular Pacemakers (Cardiac Resynchronization Therapy) for the Treatment of Heart Failure
- Blepharoplasty, Brow Lift and Ptosis Repair
- Bone Growth Stimulators: Ultrasound
- Bone Morphogenetic Protein
- Bronchial Thermoplasty
- Cardioverter Defibrillator: Implantable
- Cataract Removal Surgery
- Chemical Peels
- Cochlear Implant
- Composite Tissue Allotransplantation (CTA) of the Hand and Face
- Computer-Assisted Endoscopic Sinus Surgery
- Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure
- Confocal Laser Endomicroscopy
- Cranial Electrotherapy Stimulation (CES) and Auricular Electrostimulation
- Cryoablation of Prostate Cancer
- Cryosurgical Ablation of Miscellaneous Solid Tumors Other than Liver, Prostate, or Dermatologic Tumors
- Decompression of the Intervertebral Disc Using Laser Energy (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty)
- Deep Brain Stimulation
- Dermabrasion
- Disposable Arthroscopy
- Donor Lymphocyte Infusion for Malignancies Treated with an Allogeneic Hematopoietic Stem-Cell Transplant
- Endobronchial Valves
- Endometrial Ablation
- Endoscopic Radiofrequency Ablation or Cryoablation for Barretts Esophagus
- Endovascular Procedures (Angioplasty and/or Stenting) for Intracranial Arterial Disease (Atherosclerosis and Aneurysms)
- Extracorporeal Shock Wave Lithotripsy (ESWL) for Pancreatic Stones
- Extracorporeal Shock Wave Lithotripsy of Renal Stones
- Extracranial Carotid Angioplasty/Stenting
- Eyelid Thermal Pulsation for the Treatment of Dry Eye Syndrome
- Facet Arthroplasty
- Facet Joint Denervation
- Fetal Surgery for Prenatally Diagnosed Malformations
- Gastric Electrical Stimulation
- Gynecomastia Surgery
- Handheld Radiofrequency Spectroscopy for Intraoperative Assessment of Surgical Margins During Breast-Conserving Surgery
- Heart Transplant
- Heart/Lunt Transplant
- Hematopoietic Stem Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma
- Hematopoietic Stem-Cell Transplantation for Acute Lymphoblastic Leukemia
- Hematopoietic Stem-Cell Transplantation for Autoimmune Diseases
- Hematopoietic Stem-Cell Transplantation for Breast Cancer
- Hematopoietic Stem-Cell Transplantation for Chronic Myelogenous Leukemia
- Hematopoietic Stem-Cell Transplantation for CNS Embryonal Tumors and Ependymoma
- Hematopoietic Stem-Cell Transplantation for Epithelial Ovarian Cancer
- Hematopoietic Stem-Cell Transplantation for Hodgkin Lymphoma
- Hematopoietic Stem-Cell Transplantation for Miscellaneous Solid Tumors in Adults
- Hematopoietic Stem-Cell Transplantation for Primary Amyloidosis
- Hematopoietic Stem-Cell Transplantation for Solid Tumors of Childhood
- Hematopoietic Stem-Cell Transplantation for Waldenstrom Macroglobulinemia
- Hematopoietic Stem-Cell Transplantation in the Treatment of Germ-Cell Tumors
- Hip Resurfacing
- Image-Guided Minimally Invasive Lumbar Decompression for Spinal Stenosis
- Implantable Bone Conduction and Bone-Anchored Hearing Aids (BAHA)
- Implantable Infusion Pump
- Implantable Sinus Spacers and Stents for Postoperative Use Following Endoscopic Sinus Surgery
- Injectable Bulking Agents for the Treatment of Urinary and Fecal Incontinence
- Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers)
- Interspinous Fixation (Fusion) Devices
- Interventions for Progressive Scoliosis
- Intraductal Biopsy/Breast Duct Endoscopy
- Intrastromal Corneal Ring Segments, ICRS, INTACS
- Intratympanic Dexamethasone for the Treatment of Menieres Disease and-or Sudden Hearing Loss
- Islet Transplantation
- Isolated Limb Perfusion/Infusion for Malignant Melanoma
- Isolated Small Bowel Transplant
- Joint Manipulation under Anesthesia (Excluding Spine)
- Kidney Transplant
- Laparoscopic and Percutaneous Techniques for the Myolysis of Uterine Fibroids
- Laparoscopic Radical Prostatectomy
- Laser Treatment of Active Acne
- Liver Transplant
- Lumbar Spinal Fusion Surgery
- Lung and Lobar Lung Transplant
- Lung Volume Reduction Surgery for Severe Emphysema
- Macugen (Pegaptanib)
- Management of Excessive Skin and Subcutaneous Tissue
- Management of Varicose Veins
- Meniscal Allografts and Collagen Meniscus Implants
- Microwave Tumor Ablation
- Minimally Invasive Lumbar Interbody Fusion
- Mohs Micrographic Surgery
- Natural Orifice Transluminal Endoscopic Surgery (NOTES)
- Nerve Graft in Association with Radical Prostatectomy
- Occipital Nerve Stimulation
- Occlusion of Uterine Arteries Using Transcatheter Embolization or Laparoscopic Occlusion to Treat Uterine Fibroids
- Ocriplasmin for Symptomatic Vitreomacular Adhesion
- Ocular Photoscreening in the Primary Care Physician?s Office as a Screening Tool to Detect Amblyogenic Factors
- Otoplasty
- Ovarian and Internal Iliac Vein Embolization as Treatment of Pelvic Congestion Syndrome
- Percutaneous Electrical Nerve Stimulation (PENS) and Percutaneous Neuromodulation Therapy (PTN)
- Percutaneous Intradiscal Electrothermal Annuloplasty (IDET) and Percutaneous Intradiscal Radiofrequency Thermocoagulation
- Percutaneous Vertebroplasty, Kyphoplasty, Mechanical Vertebral Augmentation and Sacroplasty
- Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux
- Peroral Endoscopic Myotomy (POEM) for Treatment of Esophageal Achalasia
- Photocoagulation of Macular Drusen
- Plugs for Fistula Repair
- Posterior Tibial Nerve Stimulation for Voiding and Sexual Dysfunction
- Progenitor Cell Therapy for the Treatment of Damaged Myocardium due to Ischemia
- Prolotherapy
- Prophylactic Mastectomy
- Prophylactic Oophorectomy
- Pulsed Dye Laser Treatment of Recalcitrant Verrucae
- Radiofrequency Ablation of Solid Tumors Excluding Liver Tumors
- Radiofrequency Ablation of the Renal Sympathetic Nerves as a Treatment for Resistant Hypertension
- Reduction Mammaplasty
- Reverse Shoulder Arthroplasty
- Rosacea Treatment
- Sacral Nerve Modulation/Stimulation for Pelvic Floor Dysfunction
- Saturation Biopsy for Diagnosis and Staging of Prostate Cancer
- Semi-Implantable/Implantable Middle Ear Hearing Aid for Moderate to Severe Sensorineural Hearing Loss
- Septoplasty, Rhinoplasty Repair
- Shoulder Resurfacing
- Single or Tandem Courses of Hematopoietic Stem-Cell Transplantation for Multiple Myeloma
- Small Bowel/Liver and Multivisceral Transplant
- Spinal Cord Stimulation
- Stem Cell Therapy for Peripheral Arterial Disease
- Stimulation of the Sacral Anterior Root Combined with Posterior Sacral Rhizotomy in Patients with Spinal Cord Injury
- Subtalar Arthroereisis
- Surgery for Athletic Pubalgia
- Surgical Deactivation of Headache Trigger Sites
- Surgical Management of Morbid Obesity
- Surgical Treatment of Femoroacetabular Impingement
- Surgical Ventricular Restoration
- Therapeutic Apheresis with Extracorporeal Column Immunoadsorption and Plasma Reinfusion
- Thermal Capsulorrhaphy as a Treatment of Joint Instability
- Total Ankle Replacement
- Transanal Endoscopic Microsurgery (TEMS)
- Transcatheter Aortic-Valve Implantation for Aortic Stenosis
- Transcatheter Closure of Patent Ductus Arteriosus
- Transcatheter Mitral Valve Repair
- Transcatheter Pulmonary Valve Implantation
- Transcoronary Ablation of Septal Hypertrophy (TASH)
- Transesophageal Endoscopic Therapies for Gastroesophageal Reflux Disease-GERD
- Transpupillary Thermotherapy (TTT)
- Transurethral Microwave Thermotherapy
- Treatment of Cervicogenic Headache and Occipital Neuralgia
- Treatment of Twin-Twin Transfusion Syndrome with Amnioreduction and/or Fetoscopic Laser Therapy
- Unicondylar Interpositional Spacer as a Treatment of Unicompartmental Arthritis of the Knee
- Vagus Nerve Stimulation
- Ventricular Assist Devices and Total Artificial Hearts
- Vertical Expandable Prosthetic Titanium Rib
- Videofluoroscopic/Cineradiography Evaluation of Velopharyngeal Dysfunction
- Viscocanalostomy and Canaloplasty
- Wireless Pressure Sensors in Endovascular Aneurysm Repair
Therapy
- Adoptive Immunotherapy
- Brachytherapy for Clinically Localized Prostate Cancer Using Permanently Implanted Seeds
- Chelation Therapy
- Constraint Induced Movement or Language Therapy
- Extracorporeal Photopheresis
- Functional Neuromuscular Stimulation
- Hematopoietic Stem-Cell Transplantation for Acute Myeloid Leukemia
- Hematopoietic Stem-Cell Transplantation for Non-Hodgkin Lymphomas
- Hippotherapy
- Hyperbaric Oxygen Therapy
- Immune Globulin Replacement Therapy
- Inhaled Nitric Oxide
- Inpatient Intestinal Rehabilitation Therapy
- Lipid Apheresis
- Low Level Laser and High Power Laser Therapies
- Lysis of Epidural Adhesions
- Manipulation under Anesthesia for Treatment of Chronic Spinal or Pelvic Pain
- Monochromatic Infrared Energy System
- Oxygen Therapy
- Plasma Exchange (Plasmapheresis)
- Sensory Integration Therapy, Auditory Integration Therapy and Facilitated Communication
- Sensory Stimulation for Coma Patients
- Spinal Manipulation of Non-Neuromusculoskeletal Conditions
- Sympathetic Therapy and Bioelectrical Nerve Block or Electroanalgesic Nerve Block for the Treatment of Pain
- Treatment of Hyperhidrosis
- Vertebral Axial Decompression
- Visual Perceptual Training
