Coverage Policies/Criteria Medical Categories
- Administrative (Non-Clinical Topics)
- Behavioral Health Topics
- Durable Medical Equipment (DME)
- Genetics
- Laboratory/Pathology
- Medicine (Medical Treatments/Diagnostic Tests)
- Mixed Topics
- OB/GYN (Includes Reproduction and Infertility)
- Orthotics/Prosthetics
- Other (Miscellaneous Categories)
- Prescriptions/Pharmaceuticals
- Radiology (Diagnostic/Therapeutic)
- Surgery
- Therapy (Physical/Occupational/General Rehabilitation)
- Transplants
Administrative (Non-Clinical Topics)
Behavioral Health Topics
- Attention-Deficit/Hyperactivity Disorder (ADHD): Assessment and Treatment - (0231)
- Autism Spectrum Disorders/Pervasive Developmental Disorders: Assessment and Treatment - (0447)
- Chronic Fatigue Syndrome: Diagnostic and Treatment Service - (0102)
- Cognitive Rehabilitation - (0124)
- Complementary and Alternative Medicine - (0086)
- Dialectical Behavior Therapy (DBT) - (0388)
- Deep Brain and Motor Cortex Stimulation - (0184)
- Eye Movement Desensitization and Reprocessing (EMDR) - (0374)
- Intensive Behavioral Interventions - (0499)
- Light Therapy for Seasonal Affective Disorder (SAD) - (0015)
- Neuropsychological Testing - (0258)
- Quantitative Electroencephalography (QEEG) - (0239)
- Sensory and Auditory Integration Therapy - Facilitated Communication - (0283)
- Telemedicine - (0196)
- Transcranial Magnetic Stimulation - (0383)
- Ultra-Rapid Detoxification - (0384)
- Visual Perceptual Training - (0410)
Durable Medical Equipment (DME)
- Airway Clearance Devices in the Ambulatory Setting
- Ambulatory Assistance Devices
- Ambulatory Blood Pressure Monitoring with Automatic Portable Monitors
- Bathroom and Toilet Equipment and Supplies
- Transcutaneous Electrical Joint Stimulation Devices
- Bone Growth Stimulators: Electrical (Invasive, Noninvasive), Ultrasound
- Breast Pumps
- Continuous Passive Motion (CPM) Devices
- Cooling Devices for Multiple Sclerosis
- Cryounits/Cooling Devices
- Dry Hydrotherapy
- Electrical Stimulators
- External Insulin Pumps
- Hearing Aids
- Home Apnea Monitoring for Infants
- Home Blood Glucose Monitors
- Home Hemoglobin Testing Devices
- Home Sphygmomanometers
- Home Spirometry
- Home Traction Devices: Cervical and Lumbar
- Home Uterine Activity Monitoring (HUAM)
- Hospital Beds and Accessories
- Light Therapy for Seasonal Affective Disorder (SAD)
- Lymphedema Pumps and Compression Garments
- Mechanical Devices for the Treatment of Back Pain
- Transtympanic Micropressure Device for Meniere's Disease (e.g. Meniett™ Device)
- Negative-Pressure Wound Therapy/Vacuum-Assisted Closure for Non-Healing Wounds
- Noninvasive Negative Pressure Ventilators
- Oxygen for Home Use
- Phototherapy and Photochemotherapy & Ecimer Laser Therapy for Dermatological Conditions
- Pneumatic Compression Devices for the Treatment of Vascular Diseases of the Lower Extremities
- Postoperative Continuous Local Delivery of Analgesia
- Pressure Reducing Surfaces
- Prothrombin Time Home Testing Systems
- Pulse Oximetry for Home Use
- Pulsed Electromagnetic Stimulation Therapy
- Seat Lift Mechanisms, Patient Lifts and Standing Devices
- Speech Generating Devices
- Spinal Cord Stimulation
- Stretch Devices for Joint Stiffness and Contractures
- Stuttering Treatment Devices
- Vitrectomy Chair/Vitrectomy Support System/Face-Down Positioning
- Wearable Cardioverter Defibrillator and Automatic External Defibrillator
- Wheelchairs/Power Operated Vehicles
Genetics
- Assays of Genetic Expression in Tumor Tissue as a Prognosis in Patients with Breast Cancer
- Comparative genomic Hybridzation Testing (Chromosomal Microarray Analysis)
- Down Syndrome Screening
- Drug Metabolizing Enzyme Genotyping Systems
- Gene-Based Testing for Prostate Cancer Screening, Detection and Disease Monitoring
- Genetic Counseling
- Genetic Disease Screening Panels
- Genetic Expression Assays for Breast Cancer Prognosis
- Genetic Testing
- Genetic Testing for Alzheimer's Disease
- Genetic Testing for Canavan Disease
- Genetic Testing for Congenital, Profound Deafness
- Genetic Testing for Cystic Fibrosis
- Genetic Testing for Factor V Leiden Thrombophilia
- Genetic Testing for Gaucher Disease
- Genetic Testing for Hemoglobinopathies
- Genetic Testing for Hereditary Hemochromatosis
- Genetic Testing for Long QT Syndrome (LQTS)
- Genetic Testing for Mitochondrial Disorders
- Genetic Testing for Myotonic Dystrophy Type 1
- Genetic Testing for Niemann-Pick Disease
- Genetic Testing for Retinoblastoma
- Genetic Testing for RET Proto-Oncogene Germline Point Mutations
- Genetic Testing for Susceptibility to Breast and Ovarian Cancer BRCA1 & BRCA2
- Genetic Testing for Susceptibility to Colorectal Cancer
- Genetic Testing for Tay-Sachs Disease
- Genetic Testing for von Hippel-Lindau Disease
- Genetic Testing of Heritable Disorders
- Genotypic and Phenotypic Testing for HIV Drug Resistance
- Genotyping for Thiopurine Methyltransferase Deficiency in Individuals with Inflammatory Bowel Disease
- Pharmacogenetic Testing
- Pharmacogenetic Testing for Warfarin Metabolism
- Preimplantation Genetic Diagnosis
- Tumor Markers for Diagnosis and Management of Cancer
Laboratory/Pathology
- Allergy Testing
- Antiretroviral Resistance Testing (ART)
- Assays of Genetic Expression in Tumor Tissue as a Prognosis in Patients with Breast Cancer
- Breath Test for Detection of Heart Transplant Rejection - (0456) Integrated
- Cardiac Disease Risk Assessment: Emerging Laboratory Evaluations
- Cervical Cancer Screening Technologies
- Circulating Tumor Cells Testing
- Colorectal Cancer Screening and Surveillance
- Comparative genomic Hybridzation Testing (Chromosomal Microarray Analysis)
- Drug Metabolizing Enzyme Genotyping Systems (AmpliChip™, Invader®)
- Gene-Based Testing for Prostate Cancer Screening, Detection and Disease Monitoring
- Genetic Disease Screening Panels
- Genetic Testing
- Genetic Testing for Alzheimer's Disease
- Genetic Testing for Susceptibility to Breast and Ovarian Cancer (BRCA1 & BRCA2)
- Genetic Testing for Canavan Disease
- Genetic Testing for Cogenital, Profound Deafness
- Genetic Testing for Cystic Fibrosis
- Genetic Testing for Factor V Leiden Thrombophilia
- Genetic Testing for Retinoblastoma
- Genetic Testing for Gaucher Disease
- Genetic Testing for Hemoglobinopathies
- Genetic Testing for Hereditary Hemochromatosis
- Genetic Testing for Long QT Syndrome (LQTS)
- Genetic Testing for Mitochondrial Disorders
- Genetic Testing for Myotonic Dystrophy Type 1
- Genetic Testing for von Hippel-Lindau Disease
- Genetic Testing for Niemann-Pick Disease
- Genetic Testing for RET Proto-Oncogene Germline Point Mutations
- Genetic Testing for Susceptibility to Colorectal Cancer
- Genetic Testing for Tay-Sachs Disease
- Genetic Testing of Heritable Disorders
- Genotyping for Thiopurine Methyltransferase Deficiency (TPMT) in Individuals with Inflammatory Bowel Disease (IBD)
- Pharmacogenetic Testing
- Pharmacogenetic Testing for Warfarin Metabolism
- Plasma Brain Natriuretic Peptide
- Prostate-Specific Antigen (PSA) Screening for Prostate Cancer
- Proteomic Pattern Analysis of Blood for the Early Detection of Ovarian Cancer
- Serological Testing for Inflammatory Bowel Disease
- Tests for the Evaluation of Preterm Labor
- Tumor In Vitro Chemosensitivity and Chemoresistance Assays
- Tumor Markers for Diagnosis and Management of Cancer
Medicine (Medical Treatments/Diagnostic Tests)
- Acne Procedures
- Acoustic Cardiography
- Acupuncture
- Adoptive Immunotherapy
- Allergen Immunotherapy
- Allergy Testing
- Biofeedback
- Ambulatory Blood Pressure Monitoring with Automatic Portable Monitors
- Apheresis for Hypercholesterolemia
- Benign Skin Lesion Removal
- Biofeedback
- BreastCare™/BreastAlert™ Differential Temperature Sensor
- Cardiac Event Monitors
- Cardiac Rehabilitation (Phase II Outpatient)
- Carotid Intima-Media thickness Measurement
- Chelation Therapy
- Complementary and Alternative Medicine
- Complex Lymphedema Therapy (Complete Decongestive Therapy)
- Computerized Dynamic Posturography (CDP)
- Convection-Enhanced Delivery of Therapeutic Agents to the Brain
- Diabetes Self-Management Education
- Discography
- Donor Leukocyte Infusion
- Electromyography Studies
- Electrophysiological 3-Dimensional Mapping
- Exhaled Nitric Oxide and Exhaled Breath Condensate in the Management of Respiratory Disorders
- External Counterpulsation
- Extracorporeal Electromagnetic Stimulation for Urinary Incontinence
- Foot Care Services
- Gait Analysis
- Genetic Counseling
- Genetic Testing for Retinoblastoma
- Home Dialysis and Associated Technologies
- Hospitalization for the Initiation of a Ketogenic Diet for Intractable Seizure Disorder
- Hyperbaric Oxygen Therapy, Systemic & Topical
- Hyperthermia Treatment For Cancer
- Indirect Measurement of Left Ventricular End Diastolic Filling Pressure (LVEDP): VeriCor®
- Inert Gas Rebreathing for Cardiac Output Measurement
- Inhaled Nitric Oxide (INO)
- Injections for Unilateral Vocal Cord Paralysis (UVCP)
- Inpatient Admission for Radiation Therapy
- Intensive Behavioral Interventions
- Intracranial Electroencephalography (IEEG)
- Intralesional and Intraarticular Pain Pumps
- Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
- Local Injection Therapy and Neurosurgery for Cervicogenic Headache and Occipital Neuralgia
- Low-Level Laser Therapy
- Lyme Disease Treatment
- Malignant Melanoma Surveillance Technologies
- Mechanical Devices for the Treatment of Back Pain
- Microvolt T-Wave Alternans
- Mifepristone (Mifeprex®)
- Monochromatic Infrared Energy Therapy (Anodyne® Therapy)
- Neonatal Auditory Screening
- Nerve Conduction Velocity Studies Including Late Response (H-reflex and F-wave)
- Neuropsychological Testing
- Nutritional Counseling
- Nutritional Support
- Obstructive Sleep Apnea Diagnosis and Treatment Services
- Oral Screening Systems
- Pediatric Intensive Feeding Programs
- Photodynamic Therapy for Dermatologic and Ocular Conditions
- Phototherapy and Photochemotherapy & Excimer Laser Therapy for Dermatological Conditions
- Plasma Brain Natriuretic Peptide
- Plasmapheresis
- Preoperative Inpatient Admissions
- Prolotherapy
- Quantitative Electroencephalography (QEEG)
- Quantitative Sensory Testing (QST)
- Serological Testing for Inflammatory Bowel Disease
- Computerized Electrocardiograph (ECG) Analysis
- Somatosensory Evoked Potentials
- Suit Therapy
- Telemedicine
- Thermography/Temperature Gradient Studies
- Thoracic Electrical Bioimpedance for the Measurement of Cardiac Output
- Tilt Table Testing
- Tinnitus Treatment Services and Devices
- Transjugular Intrahepatic Portosystemic Shunts (TIPS)
- Vestibular Rehabilitation and Particle Repositioning Maneuvers
- Video Electroencephalographic (V-EEG) Monitoring
- Vision Therapy/Orthoptics
Mixed Topics
- Acne Procedures
- Actinic Keratosis Treatments
- Airway Clearance Devices in the Ambulatory Setting
- Anesthesia and Facility Services for Dental Treatment
- Attention-Deficit/Hyperactivity Disorder (ADHD): Diagnosis and Treatment
- Autism Spectrum Disorders/Pervasive Developmental Disorders: Assessment and Treatment
- Benign Prostatic Hypertrophy (BPH) Treatments
- Bone Growth Stimulators: Electrical (Invasive, Noninvasive), Ultrasound
- Bone Mineral Density Measurement
- Chronic Fatigue Syndrome: Diagnostic and Treatment Services
- Colorectal Cancer Screening and Surveillance
- Complementary and Alternative Medicine
- Corneal Remodeling
- Diabetic Supplies
- Hyperhidrosis Treatments
- Infertility Services
- Internal/External Cardioverter Defibrillators
- Invasive Treatments for Urinary Incontinence
- Lymphedema Pumps and Compression Garments
- Minimally Invasive Treatment of Back Pain and Neck Pain
- Observation Care
- Obstructive Sleep Apnea Diagnosis and Treatment Services
- Plantar Fasciitis Treatments
- Recurrent Pregnancy Loss: Diagnosis and Treatment
- Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome Treatment
- Scar Revision
- Scoliosis Treatments, Idiopathic
- Tinnitus Treatment Services and Devices
- Treatment of Cutaneous Hemangioma, Port Wine Stain and Other Vascular Lesions
- Varicose Vein Treatments
- Tissue-Engineered Skin Substitutes and Platelet-Derived Growth Factors
OB/GYN (Includes Reproduction and Infertility)
- Amnioinfusion
- Brachytherapy for Gynecological Cancers
- Breast Biopsy Procedures including Sentinel Node Biopsy
- Breast Pumps
- Breast Reconstruction Following Mastectomy or Lumpectomy
- Cervical Cancer Screening Technologies
- Down Syndrome Screening
- Embolization for Pelvic Congestion
- Endometrial Ablation
- Fetal Surgery
- Genetic Expression Assays for Breast Cancer Prognosis
- Genetic Testing for Susceptibility to Breast and Ovarian Cancer (e.g., BRCA1 & BRCA2)
- Home Uterine Activity Monitoring
- Hysterectomy
- Hysteroscopic Tubal Sterilization
- Infertility Services
- Magnetic Resonance (MR)-Guided Thermal Ablation of Fibroids
- Mammography
- Mifepristone (RU 486)
- Pelvic Denervation Procedures
- Preimplantation Genetic Diagnosis
- Prophylactic Mastectomy
- Prophylactic Oophorectomy With or Without Hysterectomy
- Proteomic Pattern Analysis of Blood for the Early Detection of Ovarian Cancer
- Recurrent Pregnancy Loss: Diagnosis and Treatment
- Reduction Mammoplasty
- Stem-Cell Transplantation for Epithelial Ovarian Cancer
- Tests for the Evaluation of Preterm Labor
- Transvaginal Ultrasound for Ovarian and Endometrial Cancer Screening or Surveillance
- Ultrasound In Pregnancy (including 3D and 4D Ultrasound
- Uterine Artery Embolization
Orthotics/Prosthetics
- Cranial Orthotic Devices for Positional or Deformational Plagiocephaly
- Devices for Voice Rehabilitation Following Total Laryngectomy
- External BreastProstheses and Mastectomy Bras Following Mastectomy or Lumpectomy
- Facial Prostheses, External
- Knee Braces
- Lower Limb Prosthetic Devices (Including Vacuum-Assisted Socket System and Microprocessor/Computer-Controlled Lower Limb Prostheses - (0194)
- Myoelectric Prostheses - (0233)
- Penile Prostheses for Erectile Dysfunction and External Erectile Aids - (0055)
- Spinal Orthoses
- Suit Therapy
Other (Miscellaneous Categories)
- Acoustic Cardiography
- Acupuncture
- Adoptive Immunotherapy
- Anesthesia and Facility Services for Dental Treatment
- Apheresis for Hypercholesterolemia
- Biofeedback
- Biventricular Pacing/Cardiac Resynchronization Therapy (CRT)
- BreastCare™/BreastAlert™ Differential Temperature Sensor
- Carotid Intima-Media thickness Measurement
- Chelation Therapy
- Chiropractic Care
- Coma Stimulation
- Complementary and Alternative Medicine
- Computerized Dynamic Posturography (CDP)
- Convection-Enhanced Delivery of Therapeutic Agents to the Brain
- Cooling Devices for Multiple Sclerosis
- Cranial Orthotic Devices for Positional or Deformational Plagiocephaly
- Distraction Osteogenesis (DO) for Craniofacial Deformities
- Diabetes Self-Management Education
- Diabetic Supplies
- Dialectical Behavior Therapy (DBT)
- Electrical Stimulators
- External Counterpulsation
- Extracorporeal Electromagnetic Stimulation for Urinary Incontinence
- Electrophysiological 3-Dimensional Mapping
- Extracorporeal Immunoadsorption with Protein A Column(ECI) Plasma Therapy
- Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions
- Eye Movement Desensitization and Reprocessing (EMDR)
- Foot Care Services
- Gait Analysis
- Weighted Eyelid Implants
- Hearing Aids
- Home Dialysis and Associated Technologies
- Hospice Care
- Hospitalization for the Initiation of a Ketogenic Diet for Intractable Seizure Disorder
- Hyperbaric Oxygen Therapy, Systemic & Topical
- Hyperthermia Treatment For Cancer
- Implantable Infusion Pumps for Non-Pain Conditions
- Indirect Measurement of Left Ventricular End Diastolic Filling Pressure (LVEDP): VeriCor®
- Inert Gas Rebreathing for Cardiac Output Measurement
- Inhaled Nitric Oxide (INO)
- Injectable Bulking Agents for Urinary Conditions and Fecal Incontinence
- Injections for Unilateral Vocal Cord Paralysis (UVCP)
- Inpatient Acute Rehabilitation
- Inpatient Admission for Radiation Therapy
- Intestinal Rehabilitation Programs
- Intraperitoneal Hyperthermic Chemotherapy (IPHC)
- Lyme Disease Treatment
- Malignant Melanoma Surveillance Technologies
- Massage Therapy
- Exhaled Nitric Oxide and Exhaled Breath Condensate in the Management of Respiratory Disorders
- Transtympanic Micropressure Device for Meniere's Disease (e.g. Meniett™ Device)
- Microvolt T-Wave Alternans
- Microwave Thermotherapy for Breast Cancer
- Monochromatic Infrared Energy Therapy (Anodyne® Therapy)
- Negative-Pressure Wound Therapy/Vacuum-Assisted Closure (VAC) for Non-Healing Wounds
- Neonatal Auditory Screening
- Nutritional Counseling
- Nutritional Support
- Observation Care
- Oral Screening Systems
- Outpatient Acute Rehabilitation
- Oxygen for Home Use
- Pediatric Intensive Feeding Programs
- Photopheresis (Extracorporeal Photochemotherapy)
- Plasmapheresis
- Postoperative Continuous Local Delivery of Analgesia
- Prolotherapy
- Quantitative Sensory Testing (QST)
- Reflex Sympathetic Dystrophy/Complex Regional Pain syndrome Treatment
- Rosacea Procedures
- Selective Internal Radiation Therapy (SIRT)
- Sensory and Auditory Integration Therapy - Facilitated Communication
- Computerized Electrocardiograph (ECG) Analysis
- Spinal Cord Stimulation
- Stuttering Treatment Devices
- Suit Therapy
- Telemedicine
- Thermography/Temperature Gradient Studies
- Thoracic Electrical Biompedance for the Measurement of Cardiac Output
- Tilt Table Testing
- Transarterial Chemoembolization
- Transjugular Intrahepatic Portosystemic Shunts (TIPS)
- Transpupillary Thermal Therapy (TTT) for Choroidal Tumors and Macular Degeneration
- Ultra-Rapid Detoxification
- Umbilical Cord Blood Banking
- Ventilator Weaning
- Vestibular Rehabilitation and Particle Repositioning Maneuvers
- Visual Perceptual Training
- Vitrectomy Chair/Vitrectomy Support System/Face-Down Positioning
- Wearable Cardioverter Defibrillator and Automatic External Defibrillator
- Work Hardening Programs
- Tissue-Engineered Skin Substitutes and Growth Factors
Radiology (Diagnostic/Therapeutic)
- Bone Mineral Density Measurement
- Brachytherapy Following Femoropopliteal Percutaneous Transluminal Angioplasty (PTA)
- Brachytherapy for Breast Cancer
- Brachytherapy for Prostate Cancer
- Brachytherapy of the Coronary Arteries
- Capsule Endoscopy
- Cardiac Nuclear Imaging
- Cardiovascular Magnetic Resonance (CMR)
- Carotid Intima-Media Thickness Measurement>
- Computed Tomography Angiography (CTA)
- Computed Tomography for Whole-Body Screening
- Computer-Aided Detection of Chest Radiographs for Lung Cancer Screening
- Defecography
- Discography
- Dynamic Spinal Visualization
- Electrical Impedance Scanning (EIS) and Optical Imaging of the Breast
- Electromagnetic Navigation Bronchoscopy
- Electron Beam Computed Tomography (EBCT) and Multidetector Computed Tomography (MDCT)for Coronary Artery Calcification
- Functional Magnetic Resonance Imaging (fMRI) Brain
- Intensity-Modulated Radiation Therapy (IMRT)
- Intravascular Ultrasound (IVUS)
- Magnetic Resonance Angiography (MRA)
- Magnetic Resonance Cholangiopancreatography (MRCP)
- Magnetic Resonance Imaging (MRI) Cardiovascular (CV)
- Magnetic Resonance Imaging (MRI), Low-Field
- Magnetic Resonance Imaging (MRI) of the Breast
- Magnetic Resonance Neurography
- Magnetic Resonance Spectroscopy (MRS)
- Magnetoencephalography (MEG)
- Mammary Ductoscopy (MD)
- Mammography
- Neutron Beam Therapy
- Positron Emission Tomography (PET)
- Proton Beam Therapy for Intracranial and Skull Base Tumors
- Proton Beam Therapy for Lung Cancer
- Proton Beam Therapy for Ocular Melanoma, Ocular Hemangiomas and Macular Degeneration
- Proton Beam Therapy for Prostate Cancer
- Selective Internal Radiation Therapy (SIRT)
- Spinal Ultrasound
- Spiral Computed Tomography for Lung Cancer Screening
- Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)
- Thermography/Temperature Gradient Studies
- Transcranial Doppler (TCD) Ultrasonography
- Transrectal Ultrasound (TRUS)
- Transvaginal Ultrasound for Ovarian and Endometrial Cancer Screening or Surveillance
- Ultrasound In Pregnancy (including 3D and 4D Ultrasound)
- Computed Tomography Colonography/Virtual Colonoscopy
- Whole Body Dual X-Ray Absorptiometry (DXA)
- Wireless Gastrointestinal Motility Monitoring System (SmartPill&3174;)
Surgery
- Actinic Keratosis Treatments
- Adrenal-to-Brain and Fetal Mesencephalic Transplantation for Parkinson Disease
- Allograft Transplantation of the Knee, (Anterior Cruciate and Meniscal
- Amnioinfusion
- Amniotic Membrane Transplant for the Treatment of Ocular Conditions
- Arthroscopic Lavage and Debridement of the Knee for the Treatment of Osteoarthritis and Other Knee Conditions
- Artificial Retinal Devices
- Autologous Skeletal Myoblast Transplant/Autologous Cell Therapy for Cardiac and Peripheral Arterial Disease
- Bariatric Surgery
- Barnett Continent Intestinal Reservoir (BCIR)
- Benign Prostatic Hypertrophy (BPH) Treatments
- Benign Skin Lesion Removal
- Biventricular Pacing/Cardiac Resynchronization Therapy (CRT)
- Blepharoplasty, Reconstructive Eyelid Surgery and Brow Lift
- Bone Graft Substitutes for Use in Bone Repair
- Brachytherapy Following Femoropopliteal Percutaneous Transluminal Angioplasty (PTA)
- Brachytherapy for Breast Cancer
- Brachytherapy for Gynecological Cancers
- Brachytherapy for Prostate Cancer
- Breast Biopsy Procedures including Sentinel Node Biopsy
- Breast Implant Removal
- Breast Reconstruction Following Mastectomy or Lumpectomy
- Carotid Artery Stenting for Carotid Artery Stenosis
- Chondrocyte Implantation of The Knee
- Cochlear and Auditory Brainstem Implants
- Corneal Remodeling
- Corneal Transplant
- Brachytherapy of the Coronary Arteries
- Cryoablation for Prostate Cancer
- Cryoablation for Renal Tumors
- Cryoablation of Breast Lesions
- Deep Brain and Motor Cortex Stimulation
- Diaphragmatic/Phrenic Nerve Stimulation
- Devices for Voice Rehabilitation Following Total Laryngectomy
- Distraction Osteogenesis (DO) for Craniofacial Deformities
- Drug-Eluting Stents for Ischemic Heart Disease
- Embolization for Pelvic Congestion
- Emerging Surgical Procedures for Glaucoma
- Endometrial Ablation
- Endoscopic Anti-Reflux Procedures
- Endovascular Repair of Abdominal Aortic Aneurysms
- Endovascular Repair of Thoracic Aortic Aneurysms
- Excimer Laser Coronary Angioplasty (ELCA)
- Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions
- Fetal Surgery
- Frenulotomy/Frenuloplasty for Ankyloglossia
- Gastric Pacing/Gastric Electrical Stimulation (GES)
- Gender Reassignment Surgery
- Hip surgery for Femoroacetabular Impingement (FAI) Syndrome
- Weighted Eyelid Implants
- Hammer Toe Surgery
- Hip Resurfacing Arthroplasty
- Hyperhidrosis Treatments
- Hysteroscopic Tubal Sterilization
- Hysterectomy
- Ilizarov Technique
- Implantable Cardioverter Defibrillator (ICD)
- Implantable Infusion Pumps for Non-Pain Conditions
- Injectable Bulking Agents for Urinary Conditions and Fecal Incontinence
- Interspinous Process Spacer Devices (e.g., X-STOP®)
- Intervertebral Disc (IVD) Prosthesis
- Intracranial Electroencephalography (IEEG)
- Intraocular Lens (IOL) Implant
- Invasive Treatments for Urinary Incontinence
- Knee Arthroplasty Replacement
- Local Injection Therapy and Neurosurgery for Cervicogenic Headache and Occipital Neuralgia
- Lumbar Fusion for Spinal Instability and Degenerative Disc Conditions
- Lung Volume Reduction Surgery (LVRS)
- Magnetic Resonance (MR)-Guided Thermal Ablation of Fibroids
- Maze Procedure
- Metatarsophalangeal Joint Replacement
- Microwave Thermotherapy for Breast Cancer
- Minimally Invasive Total Hip Arthroplasty
- Minimally Invasive Treatment of Back Pain and Neck Pain
- Mohs’ Micrographic Surgery
- Orthognathic Surgery
- Osteochondral Grafts for Articular Cartilage Repair (Autografts, Allografts, and Synthetic Grafts)
- Otoplasty and External Ear Reconstruction
- Pancreatic Islet Cell Transplantation
- Panniculectomy and Abdominoplasty
- Partial Left Ventriculectomy, Dynamic Cardiomyoplasty and Ventricular Reshaping in the Treatment of Heart Failure
- Preoperative Inpatient Admissions
- Pelvic Denervation Procedures
- Penile Prostheses for Erectile Dysfunction and External Errectile Aids (0055)
- Percutaneous Alcohol Septal Ablation for Hypertrophic Cardiomyopathy
- Percutaneous Vertebroplasty, Kyphoplasty and Sacroplasty
- Plantar Fasciitis Treatments
- Preoperative Inpatient Admissions
- Prophylactic Mastectomy
- Prophylactic Oophorectomy or Salpingo-oophorectomy With or Without Hysterectomy
- Radiofrequency Ablation (RFA) for Bony Metastases
- Radiofrequency Ablation (RFA) for Osteoid Osteoma
- Radiofrequency Ablation (RFA) for Primary and Metastatic Cancers of the Liver
- Radiofrequency Ablation (RFA) for the Treatment of Trigeminal Neuralgia
- Radiofrequency Ablation for Breast Cancer
- Radiofrequency Ablation (RFA) of Pulmonary Tumors
- Radiofrequency Ablation (RFA) of Renal Masses
- Rosacea Procedures
- Reduction Mammoplasty
- Redundant Skin Surgery
- Rhinoplasty/Septoplasty
- Sacral Nerve Stimulation For Urinary Voiding Dysfunction and Fecal Incontinence
- Scar Revision
- Scoliosis Treatments, Idiopathic
- Spinal Cord Stimulation
- Manipulation Under Anesthesia (MUA)
- Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)
- Strabismus Correction, Surgical
- Subtalar Arthroereisis
- Surgery for Male Sexual Dysfunction
- Surgical Treatment for Chest Wall Deformities
- Surgical Treatment of Gynecomastia
- Temporomandibular Joint (TMJ) Disorder Surgery
- Thermal Shrinkage of Joint Capsules, Ligaments and Tendons
- Titanium Rib Implants-Vertical Expandable Prosthetic Titanium Rib (VEPTR)
- Total Ankle Arthroplasty/Replacement
- Total Artificial Heart
- Total Hip Replacement with Metal-On-Metal and Ceramic-On-Ceramic Prostheses
- Transanal Radiofrequency Therapy for Fecal Incontinence (e.g., Secca® Procedure)
- Transcatheter Ablation of Arrhythmogenic Foci in the Pulmonary Veins for the Treatment of Atrial Fibrillation
- Transarterial Chemoembolization
- Transcatheter Aortic and Pulmonary Valve Implantation
- Transcatheter Closure of Septal Defects
- Transcranial Magnetic Stimulation
- Transmyocardial Revascularization (TMR) and Percutaneous Myocardial Revascularization (PMR)
- Transpupillary Thermal Therapy (TTT) for Choroidal Tumors and Macular Degeneration
- Treatment of Cutaneous Hemangioma, Port Wine Stain and Other Vascular Lesions
- Uterine Artery Embolization
- Vagus Nerve Stimulation (VNS)
- Varicose Vein Treatments
- Ventricular Assist Devices (VADs) and Percuteneous Cardiac Support Systems
Therapy (Physical/Occupational/General Rehabilitation)
- Acupuncture
- Aural Rehabilitation
- Cardiac Rehabilitation (Phase II Outpatient)
- Chiropractic Care
- Cognitive Rehabilitation
- Coma Stimulation
- Complex Lymphedema Therapy (Complete Decongestive Therapy)
- Dry Hydrotherapy
- Inpatient Acute Rehabilitation
- Low-Level Laser Therapy
- Massage Therapy
- Nerve Conduction Velocity Studies Including Late Response (H-reflex and F-wave)
- Occupational Therapy - (0232)">Occupational Therapy - (0232) Integrated
- Outpatient Acute Rehabilitation
- Physical Therapy
- Pulmonary Rehabilitation (PR)
- Speech Therapy for Swallowing and Feeding Disorders
- Speech/Language Therapy - (0177)
- Vision Therapy/Orthoptics
- Work Hardening Programs
Transplants
- Adrenal-to-Brain and Fetal Mesencephalic Transplantation for Parkinson Disease
- Amniotic Membrane Transplant for the Treatment of Ocular Conditions
- Autologous Skeletal Myoblast Transplant/Autologous Cell Therapy for Cardiac and Peripheral Arterial Disease
- Breath Test for Detection of Heart Transplant Rejection
- Corneal Transplant
- Donor Leukocyte Infusion
- Extracorporeal Immunoadsorption with Protein A Column
- Heart Transplantation
- Intestinal Rehabilitation Programs
- Kidney Transplantation
- Liver Transplantation
- Lung Transplantation
- Pancreas-Kidney Transplantation and Pancreas Transplantation Alone
- Pancreatic Islet Cell Transplantation
- Photopheresis (Extracorporeal Photochemotherapy)
- Intestinal and Multivisceral Transplant
- Stem-Cell Transplantation for Acute Lymphocytic/Lymphoblastic Leukemia
- Stem-Cell Transplantation for Acute Myelogenous Leukemia
- Stem-Cell Transplantation for Adult Solid Tumors
- Stem-Cell Transplantation for Amyloidosis
- Stem-Cell Transplantation for Aplastic Anemia
- Stem-Cell Transplant for Autoimmune Diseases
- Stem-Cell Transplant for Breast Cancer
- Stem-Cell Transplant for Central Nervous System Tumors
- Stem-Cell Transplantation for Chronic Lymphocytic Leukemia
- Stem-Cell Transplantation for Chronic Myelogenous Leukemia
- Stem-Cell Transplantation for Chronic Myelomonocytic Leukemia (CMML) and Juvenile Myelomonocytic Leukemia (JMML)
- Stem-Cell Transplantation for Epithelial Ovarian Cancer
- Stem-Cell Transplantation for Hodgkin Disease
- Stem-Cell Transplant for Inherited Immunodeficiency Disorders
- Stem-Cell Transplantation for Multiple Myeloma and POEMS Syndrome
- Stem-Cell Transplantation for Myelodysplastic Syndrome
- Stem-Cell Transplantation for Myelofibrosis
- Stem-Cell Transplantation for Neuroblastoma
- Stem-Cell Transplantation for Non-Hodgkin’s Lymphoma
- Stem-Cell Transplant for Pediatric Solid Tumors
- Stem-Cell Transplantation for Polycythemia Vera
- Stem-Cell Transplant for Primary Metabolic Disorders
- Stem-Cell Transplantation for Renal Cell Carcinoma
- Stem-Cell Transplant for Sickle Cell Disease and Thalessemia Major
- Stem-Cell Transplantation for Testicular Cancer
- Total Artificial Heart
- Transplant Donor Charges
- Umbilical Cord Blood Banking
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