Clinical Policies

Navigate directly to a letter:

A
B
C
D
E
F
G
H
I
K
L
M
N
P
R
S
T
V
W
Z

A
- Ambulatory continuous peripheral nerve block for chronic pain
- Autologous fat grafting and injectable soft-tissue fillers
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B
- Balloon Spacer Devices for Management of Massive Rotator Cuff Tears
- Balloon dilation of the Eustachian tube
- Biofeedback for chronic pain
- Bone graft substitutes
- Bone marrow transplant for children with hyper IgM disorder
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C
- Cecostomy for fecal incontinence
- Cervical Traction Devices for Neck Pain for Home Use
- Cervical cancer and human papillomavirus screening
- Computer-aided detection and diagnosis for chest imaging
- Computerized gait analysis
- Core decompression for avascular necrosis of the hip
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D
- Donor human milk
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E
- Endovenous stents.
- EpiSign Testing for DNA Methylation Analysis
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F
- Flexitouch® pneumatic compression devices for lymphedema after head and neck surgery
- Fluorescence spectroscopy for prostate cancer diagnosis
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G
- Gastrointestinal electrical stimulation for obesity
- Gastroparesis Evaluations
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H
- Hidradenitis Suppurativa Surgery
- Home-use Light Box Therapy for Seasonal Affective Disorder
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I
- Injectable bulking agents — fecal incontinence
- Intermittent pneumatic compression for peripheral artery disease
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K
- Ketone monitor for ketogenic diet in epilepsy
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L
- Lipoprotein apheresis
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M
- Medical three-dimensional printing
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N
- Nonpharmacologic treatments for chronic vertigo
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P
- Pediatric Intensive Feeding Programs
- Pediatric Turbinoplasty
- Pediatric bed enclosures
- Percutaneous arteriovenous fistula creation
- Percutaneous sacroplasty
- Peroral endoscopic myotomy
- Pet therapy
- Physician’s Drug Program
- Platelet rich plasma for nonhealing diabetic wounds
- Prostatic urethral lift/UroLift for benign prostatic hyperplasia
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R
- Radiofrequency ablation for nasal valve collapse
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S
- Shoe Lifts for Leg Length Discrepancy
- Sialendoscopy and lithotripsy for salivary stones
- Skin Substitutes for Chronic Wounds
- Smell and taste dysfunction testing
- Specialized infant formula
- Sphenopalatine ganglion block injections for headache
- Stereotactic navigation in sinus surgery
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T
- Three-dimensional imaging and interpretation
- Transcatheter Therapy for Severe Tricuspid Insufficiency
- Transcatheter pulmonary valve replacement
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V
- Vaginitis Diagnostic Testing
- Video head impulse testing
- Vitamin D screening
- Volatile organic compounds for urinary tract infection
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W
- Wheelchair mounted robotic arm – Kinova Jaco2
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Z
- ZOLL Heart Failure Management System
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