Adcetris | Drug Policy | KY Medicare | 07/15/2018 |
Adcetris | Drug Policy | OH Medicare | 07/15/2018 |
Alimta | Drug Policy | NC Medicare | 07/15/2018 |
Ambulance (Ground) | Medical Policy | OH Medicare | 09/16/2019 |
Ambulance Services (Air) | Medical Policy | OH Medicare | 09/16/2019 |
Ambulance Services (Air/Ground) | Medical Policy | NC Medicare |
09/16/2019 |
Ambulance Services (Ground) (L35162) | Medical Policy | PA Medicare |
09/20/2021 |
Ambulance Services(Air) | Medical Policy | PA Medicare | 09/20/2021 |
Ambulatory Blood Pressure Monitors | Medical Policy | NC Medicare | 07/15/2019 |
Ambulatory Blood Pressure Monitors | Medical Policy | OH Medicare | 07/15/2019 |
Ambulatory Blood Pressure Monitors (NCD 20.19) | Medical Policy | PA Medicare | 09/20/2021 |
Assessing Suitability for Electrical Nerve Stimulation Therapy | Medical Policy | NC Medicare | 05/20/2019 |
Assessing Suitability for Electrical Nerve Stimulation Therapy | Medical Policy | OH Medicare | 05/20/2019 |
Assessing Patient’s Suitability for Electrical Nerve Stimulation Therapy (160.7.1 & 160.7) | Medical Policy | PA Medicare | 02/15/2021 |
Automatic External Defibrillators |
Medical Policy | NC Medicare |
05/06/2019 |
Automatic External Defibrillators |
Medical Policy | OH Medicare |
05/06/2019 |
Automatic External Defibrillators(AED) (1.33690) |
Medical Policy | PA Medicare |
04/19/2021 |
Biomarkers Overview (L35062) | Medical Policy | PA Medicare | 12/20/2021 |
Brineura | Drug Policy | NC Medicare | 09/16/2019 |
Brineura | Drug Policy | OH Medicare | 09/16/2019 |
Bronchial Thermoplasty | Medical Policy | NC Medicare | 07/15/2019 |
Bronchial Thermoplasty | Medical Policy | PA Medicare | 07/19/2021 |
Bronchial Thermoplasty | Medical Policy | OH Medicare | 07/15/2019 |
Cardiac Event Detection Monitoring | Medical Policy | OH Medicare | 03/18/2019 |
Cardiac Event Detection Monitoring | Medical Policy | NC Medicare | 03/18/2019 |
Cardiac Pacemaker Evaluation Services | Medical Policy | NC Medicare | 03/18/2019 |
Cardiac Pacemaker Evaluation Services | Medical Policy | OH Medicare | 03/18/2019 |
Cardiac Radionuclide Imaging | Medical Policy | NC Medicare | 06/01/2018 |
Cardiac Rhythm Device Evaluation (L34833) | Medical Policy | PA Medicare | 03/15/2021 |
Carpal Tunnel | Medical Policy | NC Medicare | 09/16/2019 |
Carpal Tunnel | Medical Policy | OH Medicare | 09/16/2019 |
Carpal Tunnel | Medical Policy | PA Medicare | 09/20/2021 |
Cataract Extraction (including Complex Cataract Surgery) | Medical Policy | PA Medicare | 04/19/2021 |
Cataract Extraction | Medical Policy | NC Medicare | 07/15/2019 |
Cataract Extraction | Medical Policy | OH Medicare | 07/15/2019 |
Chromosomal Microarray Analysis: Comparative Genomic Hybridization (CGH) and Single Nucleotide Polymorphism (SNP) (L35062)
| Medical Policy | PA Medicare | 08/16/2021 |
Chromosomal Microarray Analysis: Comparative Genomic Hybridization (CGH) and Single Nucleotide Polymorphism (SNP) | Medical Policy | NC Medicare | 08/12/2019 |
Chromosomal Microarray Analysis: Comparative Genomic Hybridization (CGH) and Single Nucleotide Polymorphism (SNP) | Medical Policy | OH Medicare | 08/12/2019 |
Cochlear Implantation | Medical Policy | NC Medicare | 05/20/2019 |
Cochlear Implantation | Medical Policy | OH Medicare | 05/20/2019 |
Cochlear Implantation (NCD 50.3) | Medical Policy | PA Medicare | 12/20/2021 |
CPAP for Obstructive Sleep Apnea (OSA) | Medical Policy | NC Medicare | 06/17/2019 |
CPAP for Obstructive Sleep Apnea (OSA) | Medical Policy | OH Medicare | 06/17/2019 |
CV Nuclear Medicine | Medical Policy | OH Medicare | 07/15/2019 |
Electrical Nerve Stimulator |
Medical Policy | NC Medicare | 05/06/2019 |
Electrical Nerve Stimulator |
Medical Policy | OH Medicare |
05/06/2019 |
Electrocardiographic Services |
Medical Policy | NC Medicare |
05/06/2019 |
Electrocardiographic Services |
Medical Policy | OH Medicare |
05/06/2019 |
Electrocardiographic Services(NCD 20.15) |
Medical Policy | PA Medicare |
04/19/2021 |
Esophagogastroduodenoscopy (EGD) | Medical Policy | NC Medicare | 08/01/2018 |
Esophagogastroduodenoscopy (EGD) | Medical Policy | OH Medicare | 08/01/2018 |
Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)(L35350) | Medical Policy | PA Medicare | 03/15/2021 |
Exondys 51 | Drug Policy | NC Medicare | 10/21/2019 |
Exondys 51 | Drug Policy | OH Medicare | 10/21/2019 |
Faslodex | Drug Policy | NC Medicare | 07/15/2018 |
Faslodex | Drug Policy | OH Medicare | 07/15/2018 |
Fecal Transplant | Medical Policy | NC Medicare | 02/18/2019 |
Fecal Microbiota Transplant | Medical Policy | PA Medicare |
02/15/2021 |
Fecal Transplant | Medical Policy | OH Medicare | 02/18/2019 |
G-CSF | Drug Policy | OH Medicare | 01/15/2019 |
G-CSF | Drug Policy | NC Medicare | 01/15/2019 |
Glucose Monitoring | Medical Policy | NC Medicare | 08/12/2019 |
Glucose Monitoring | Medical Policy | OH Medicare | 08/12/2019 |
Glucose Monitoring (L33822) | Medical Policy | PA Medicare | 08/16/2021 |
Home Oxygen Therapy | Medical Policy | NC Medicare | 01/15/2019 |
Home Oxygen Therapy | Medical Policy | OH Medicare | 01/15/2019 |
Home Oxygen Therapy (L33797) | Medical Policy | PA Medicare | 09/20/2021 |
Hyperbaric Oxygen Therapy (NCD 20.29) | Medical Policy | NC Medicare | 12/21/2020 |
Hyperbaric Oxygen Therapy | Medical Policy | OH Medicare | 12/15/2018 |
Hyperbaric Oxygen Therapy | Medical Policy | PA Medicare | 12/20/2021 |
Interleukin-5 Inhibitors | Drug Policy | NC Medicare | 01/15/2019 |
Interleukin-5 Inhibitors | Drug Policy | OH Medicare | 01/15/2019 |
Leadless Pacemaker | Medical Policy | NC Medicare | 03/18/2019 |
Leadless Pacemaker | Medical Policy | OH Medicare | 03/18/2019 |
Leadless Pacemaker (NCD 20.8.4) | Medical Policy | PA Medicare | 03/15/2021 |
MolDX: Molecular Diagnostic Tests | Medical Policy | NC Medicare | 12/15/2018 |
MolDX: Molecular Diagnostic Tests | Medical Policy | OH Medicare | 12/15/2018 |
Noninvasive Assessment of Liver Fibrosis | Medical Policy | NC Medicare | 08/12/2019 |
Noninvasive Assessment of Liver Fibrosis | Medical Policy | OH Medicare | 08/12/2019 |
Noninvasive Venous Studies | Medical Policy | KY Medicare | 06/01/2018 |
Noninvasive Venous Studies | Medical Policy | OH Medicare | 06/01/2018 |
Percutaneous Transluminal Angioplasty (PTA) | Medical Policy | NC Medicare | 07/15/2019 |
Percutaneous Transluminal Angioplasty (PTA) | Medical Policy | OH Medicare | 07/15/2019 |
Perjeta | Drug Policy | NC Medicare | 07/15/2018 |
Pharmacogenomic Testing for Warfarin Response (NCD 90.1) | Medical Policy | PA Medicare | 11/15/2021 |
Pharmacogenomic Testing for Warfarin Response | Medical Policy | NC Medicare | 11/15/2018 |
Pharmacogenomic Testing for Warfarin Response | Medical Policy | OH Medicare | 11/15/2018 |
Plethysmography | Medical Policy | NC Medicare | 05/20/2019 |
Plethysmography | Medical Policy | OH Medicare | 05/20/2019 |
Outpatient Sleep Studies | Medical Policy | PA Medicare |
07/27/2020 |
Outpatient Sleep Studies | Medical Policy | NC Medicare | 06/17/2019 |
Outpatient Sleep Studies | Medical Policy | OH Medicare | 06/17/2019 |
Pulmonary Rehabilitation | Medical Policy | NC Medicare | 07/15/2019 |
Pulmonary Rehabilitation | Medical Policy | OH Medicare | 07/15/2019 |
Self-contained Cardiac Pacemakers |
Medical Policy | NC Medicare |
05/06/2019 |
Self-contained Cardiac Pacemakers |
Medical Policy | OH Medicare |
05/06/2019 |
Self-Contained Pacemaker Monitors (NCD 20.82) |
Medical Policy | PA Medicare |
04/19/2021 |
Cardiac Pacemakers: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers (NCD 20.8.3) | Medical Policy | PA Medicare | 03/15/2021 |
Single and Dual Cardiac Pacemakers | Medical Policy | NC Medicare | 03/18/2019 |
Single and Dual Cardiac Pacemakers | Medical Policy | OH Medicare | 03/18/2019 |
Soliris | Drug Policy | NC Medicare | 01/15/2018 |
Spinal Cord Stimulation (Dorsal Column Stimulation)(1.35450) |
Medical Policy | PA Medicare |
04/19/2021 |
Spinal Cord Stimulators for Chronic Pain | Medical Policy | NC Medicare | 06/01/2018 |
Spinraza | Drug Policy | NC Medicare | 10/21/2019 |
Spinraza | Drug Policy | OH Medicare | 10/21/2019 |
Subcutaneous Implantable Cardioverter Defibrillator | Medical Policy | NC Medicare | 09/16/2019 |
Subcutaneous Implantable Cardioverter Defibrillator | Medical Policy | OH Medicare | 09/16/2019 |
Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease
(PAD) (NCD 20.35) | Medical Policy | NC Medicare | 12/21/2020 |
Supervised Exercise Therapy for PAD | Medical Policy | OH Medicare | 12/15/2018 |
Supervised Exercise Therapy for PAD | Medical Policy | PA Medicare | 12/20/2021 |
Surveillance of Implantable or Wearable Cardioverter Defibrillators | Medical Policy | NC Medicare | 03/18/2019 |
Surveillance of Implantable or Wearable Cardioverter Defibrillators | Medical Policy | OH Medicare | 03/18/2019 |
Cardiac Event Detection Monitoring (L34953) | Medical Policy | PA Medicare | 03/15/2021 |
Testing of Genetic Disease | Medical Policy | PA Medicare | 11/15/2021 |
Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults with Treatment Resistant Major Depression | Medical Policy | NC Medicare | 05/20/2019 |
Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults with Treatment Resistant Major Depression | Medical Policy | OH Medicare | 05/20/2019 |
Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults with Treatment Resistant Major Depression (LCD 34998) | Medical Policy | PA Medicare | 05/17/2021 |
Transtelephonic Monitoring |
Medical Policy | NC Medicare |
05/06/2019 |
Transtelephonic Monitoring |
Medical Policy | OH Medicare |
05/06/2019 |
Tysabri | Drug Policy | NC Medicare | 10/21/2019 |
Tysabri | Drug Policy | OH Medicare | 10/21/2019 |
Velcade | Drug Policy | NC Medicare | 01/15/2019 |
Vimizim | Drug Policy | NC Medicare |
10/21/2019 |
Vimizim | Drug Policy | OH Medicare |
10/21/2019 |
Xolair | Drug Policy | KY Medicare | 07/15/2018 |
Xolair | Drug Policy | NC Medicare | 10/21/2019 |
Xolair | Drug Policy | OH Medicare | 10/21/2019 |
Yervoy | Drug Policy | KY Medicare | 07/15/2018 |
Yervoy | Drug Policy | OH Medicare | 07/15/2018 |
Scanning Computerized Ophthalmic Diagnostic Imaging | Medical Policy | OH Medicare | 07/15/2019 |
Scanning Computerized Ophthalmic Diagnostic Imaging | Medical Policy | NC Medicare | 07/15/2019 |
Cosmetic and Reconstructive Surgery (L35090) | Medical Policy | PA Medicare | 09/20/2021 |
Vitamin D Deficiency | Medical Policy | OH Medicare | 08/12/2019 |
Panniculectomy, Abdominoplasty/ Lipectomy | Medical Policy | OH Medicare | 08/12/2019 |
Vitamin D Deficiency | Medical Policy | NC Medicare | 08/12/2019 |
Panniculectomy, Abdominoplasty/ Lipectomy | Medical Policy | NC Medicare | 08/12/2019 |
Observation Care (Hospital Outpatient) | Medical Policy | PA Medicare | 10/18/2021 |
Negative Pressure Wound Therapy (NPWT) Pumps (L33821) |
Medical Policy |
PA Medicare |
10/18/2021 |
Negative Pressure Wound Therapy |
Medical Policy |
OH Medicare |
10/21/2019 |
Negative Pressure Wound Therapy |
Medical Policy |
NC Medicare |
10/21/2019 |
Implantable Cardioverter Defibrillator (NCD 20.4) | Medical Policy | PA Medicare | 12/21/2020 |
Noninvasive Vascular Studies | Medical Policy | OH Medicare | 10/21/2019 |
Ocrevus |
Medical Policy |
NC Medicare |
10/21/2019 |
Ocrevus |
Medical Policy |
OH Medicare |
10/21/2019 |
Implantable Cardioverter Defibrillator |
Medical Policy |
NC Medicare |
10/21/2019 |
Implantable Cardioverter Defibrillator |
Medical Policy |
OH Medicare |
10/21/2019 |
Botox |
Medical Policy |
NC Medicare |
10/21/2019 |
Speech Generating Devices (L33739) |
Medical Policy |
PA Medicare |
02/15/2021 |
4Kscore Test Algorithm(L37792) |
Medical Policy |
PA Medicare |
03/15/2021 |
Micro-Invasive Glaucoma Surgery (MIGS)(L38223)
|
Medical Policy |
PA Medicare |
03/15/2021 |
Peripheral Nerve Stimulation(L37360)(160.7)
|
Medical Policy |
PA Medicare |
03/15/2021 |
Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) (1.38229) |
Medical Policy |
PA Medicare |
04/19/2021 |
Hypoglossal Stimulation for the Treatment of Obstructive Sleep Apnea |
Medical Policy |
PA Medicare |
04/13/2020 |
Pulmonary Rehabilitation | Medical Policy | PA Medicare | 07/19/2021 |
CPAP for Obstructive Sleep Apnea (OSA) | Medical Policy | PA Medicare | 07/27/2020 |
Percutaneous Transluminal Angioplasty (PTA) (NCD 20.7) | Medical Policy | PA Medicare | 07/19/2021 |
Non-Invasive Peripheral Venous Studies (L35451) | Medical Policy | PA Medicare | 07/27/2020 |
Scanning Computerized Ophthalmic Diagnostic Imaging | Medical Policy | PA Medicare | 07/27/2020 |
Acupuncture for Chronic Low Back Pain (NCD 30.3.3) | Medical Policy | PA Medicare | 01/01/2021 |
Implantable Continuous Glucose Monitors (I-CGM) (L38617)
| Medical Policy | PA Medicare | 01/17/2022 |
Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor (L38495)
| Medical Policy | PA Medicare | 01/17/2022 |
Blood Glucose Testing (NCD 190.20)
| Medical Policy | PA Medicare | 02/15/2021 |
Oral Appliances for Obstructive Sleep Apnea (L33611)
| Medical Policy | PA Medicare | 02/15/2021 |
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea (1.38385)
| Medical Policy | PA Medicare | 04/19/2021 |
Vitamin D Deficiency Screening | Medical Policy | PA Medicare |
06/21/2021 |
Osteogenic Stimulators (150.2) | Medical Policy | PA Medicare |
11/15/2021 |