|
A |
|
|
|
Abatacept |
|
Abdominal
Aortic Aneurysm, Endovascular Stent Grafting |
|
Abdominoplasty
/ Panniculectomy / Lipectomy |
|
Ablation Treatments
for Barrett’s Esophagus |
|
Absent
or Nonfunctioning Body Parts (Prosthetics), General Policy |
|
Accelerated
Fracture Healing Device, Ultrasound |
|
Acclarent
Balloon Sinuplasty™ |
|
aCGH
for the Genetic Evaluation of Individuals with Developmental Delay/Mental
Retardation |
|
Acoustic
Cardiography |
|
Acoustic
Immittance Measures for Hearing |
|
Acoustic Rhinometry |
|
Actemra® |
|
Acthar® Gel - H.P. |
|
Actigraphy
for Sleep Disorders |
|
Active
Specific Immunotherapy: Melanoma Vaccine |
|
Active
Wound Therapy |
|
Acupuncture |
|
Adcetris™ |
|
Adefovir
dipivoxil |
|
Adhesiolysis,
Epidural for Chronic Pain Syndrome |
|
Adjustable
Cranial Orthoses for Positional Plagiocephaly and Craniosynostoses |
|
Adoptive
Immunotherapy |
|
Aflibercept |
|
Agalsidase
Beta |
|
AICD
- Automatic Implantable Cardioverter Defibrillator for the Prevention
of Sudden Death |
|
Aktilite® CL128 |
|
Aldurazyme® |
|
Alefacept |
|
Alemtuzumab |
|
Alglucosidase Alfa |
|
Alimta® |
|
Allergy
Immunotherapy, |
|
|
|
|
|
|
|
Allergy
Testing, |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Allergy
Testing and Treatment, General Policy |
|
Allograft
Anterior Cruciate Ligament (ACL) Reconstruction |
|
Allograft
Transplantation, Meniscal |
|
Allografting,
Osteochondral |
|
Allomap™ |
|
Alpha
1-Proteinase Inhibitor (Human) |
|
AlphaNine® SD |
|
Alternative
Medicine |
|
Alzheimer's Disease, Genetic Testing |
|
Ambulance
Services |
|
Ambulatory
Monitoring of Uterine Contractions |
|
Amevive® |
|
Aminolevulinic
Acid for the Treatment of Actinic Keratoses |
|
Amnioreduction |
|
Amplatzer®
- Transcatheter Closure Devices for Cardiac Defects |
|
AmpliChip CYP450 Test |
|
Amyloid
Light-Chain (AL) Amyloidosis - HDC with Autologuous Stem-Cell Transplant |
|
Analysis of Human DNA in Stool Samples as
a Technique for Colorectal Cancer Screening |
|
Analysis
of Proteomic Patterns in Serum to Identify Ovarian Cancer |
|
Angioplasty,
Percutaneous Transluminal of the Aortic Arch Vessels with or without stenting
(Brachiocephalic, Carotid, Subclavian & Vertebral arteries) and of
Coarctation of the Aorta |
|
Angioplasty
and/or Stenting for Intracranial Arterial Disease |
|
Ankle - Total Replacement |
|
Antigens,
Ovarian-Tumor Assoc Assay |
|
Apolipoprotein
B Testing for Screening, Diagnosis and Management of Dyslipidemia and
Cardiovascular Disease |
|
Apolipoprotein
E Testing for Screening, Diagnosis and Management of Dyslipidemia and
Cardiovascular Disease |
|
Apolipoprotein
I Testing for Screening, Diagnosis and Management of Dyslipidemia and
Cardiovascular Disease |
|
Applied
Behavioral Analysis (ABA) |
|
Aquatic
Therapy |
|
Aralast® / Aralast
NP |
|
Aranesp® |
|
Arcalyst® |
|
Array
Comparative Genomic Hybridization (aCGH) for the Genetic Evaluation of
Individuals with Developmental Delay/Mental Retardation |
|
Art-Assist
Device™ |
|
Arterial
Elasticity for Cardiovascular Disease |
|
Arterial
Revascularization, Penile |
|
Arteriography (Angiography), Selective Internal Pudendal
for Erectile Dysfunction |
|
Arthroereisis
Implant for the Treatment of Flexible Flatfoot Conditions |
|
Arthrography,
Sacroiliac Joint |
|
Arthrography,
Shoulder |
|
Arthroplasty,
Reverse Shoulder |
|
Arthroscopy,
Temporomandibular Joint (TMJ) |
|
Artificial
Intervertebral Disc |
|
Artificial
Liver Assist Devices for the Treatment of Liver Conditions |
|
Arzerra™ |
|
Attendance, Physician at Delivery for Newborn Care |
|
Auditory
Evoked Potentials (AEP) |
|
Autologous
Cell Therapy for the Treatment of Damaged Myocardium |
|
Autologous Chondrocyte Implantation (ACI) |
|
Autologous
Hematopoietic Stem-Cell Transplantation for Malignant Astrocytomas and
Gliomas |
|
Autologous
Stem-Cell Transplant for Primary Amyloid Light-Chain (AL) Amyloidosis |
|
Autolymphocyte
Therapy (ALT) |
|
Automatic
Implantable Cardioverter Defibrillator for the Prevention of Sudden Death |
|
Avastin® |
|
Azacitidine |
|
|
|
B |
|
|
|
Balloon Dilatation of the Prostatic Urethra |
|
Balloon
Sinuplasty for Treatment of Chronic Sinusitis |
|
Balloon-based
Radiofrequency Ablation for Barrett’s Esophagus |
|
Banzel™ |
|
Baraclude® |
|
Bariatric Surgery for Morbid Obesity |
|
Baroreflex
Stimulation Devices |
|
Bebulin® VH |
|
Belimumab |
|
Bendamustine |
|
BeneFix® |
|
Benlysta® |
|
Berinert® |
|
Bevacizumab for the Treatment of Neoplastic
Disease |
|
Bexxar® |
|
Biochemical
Markers for Alzheimer’s Disease |
|
Biofeedback |
|
Bioimpedance
- Thoracic Electrical |
|
Biological
Therapy / Biotherapy |
|
Bionect® |
|
Biosynthetic
Fistula Plugs |
|
Biothesiometry for Erectile Dysfunction |
|
Birmingham
Hip Resurfacing (BHR) System |
|
Biventricular
Pacemakers for the Treatment of Heart Failure |
|
Blepharoplasty |
|
Blu-U® |
|
Blue
Light for Acne Vulgaris |
|
Body
Surface Mapping |
|
Bone
Lengthening for Congenital Conditions, Limb Discrepancies and Angular
Deformities of Long Bones |
|
Bone
Marrow Transplant |
|
Bone
Turnover Markers |
|
Boron
Neutron Capture Therapy (BNCT) for Glioblastoma Multiforme |
|
Bortezomib |
|
Botulinum Toxin |
|
Brachial Index (PBI), Penile |
|
Brachytherapy
for Breast Cancer |
|
Brachytherapy
for Malignant Gliomas or Metastases to the Brain |
|
Brachytherapy for Prostate Cancer |
|
Brain Mapping, Topographic |
|
Brain
Stimulation, Deep |
|
Brainstem
Evoked Response |
|
BRCA1,
BRCA2 or CHEK2 for Breast or Ovarian Cancer, Genetic Testing |
|
Breast,
Magnetic Resonance Imaging (MRI) |
|
Breast
Augmentation / Mammaplasty (Non-Cancerous) |
|
Breast
Cancer Tumor Markers |
|
Breast
Diseases or Conditions, General Policy |
|
Breast Duct Endoscopy |
|
Breast
Ductal Lavage for Cancer Risk Assessment |
|
Breast
Implant Removal |
|
Breast Reconstructive and Symmetry Surgery Following
Mastectomy |
|
Breast
Tomosynthesis, Digital |
|
Breathmeter |
|
Brentuximab
Vedotin |
|
Bronchial
Drainage System (Vest) |
|
Bronchial
Thermoplasty |
|
Browplasty |
|
Bulbocavernosus Reflex for Erectile Dysfunction |
|
Bulking
Agents for Stress Urinary Incontinence |
|
|
|
C |
|
|
|
C-Reactive
Protein, High Sensitivity (hs-CRP) Testing for Cardiovascular Disease
(CVD) |
|
C1
Esterase Inhibitor |
|
CA
- 125 Assay |
|
Cabazitaxel |
|
CAD
of Malignancy with Magnetic Resonance Imaging of the Breast |
|
Campath® |
|
Canakinumab |
|
Canalith
Repositioning for Benign
Paroxysmal Positional Vertigo (BPPV) |
|
Cancer
Screening of the Cervix |
|
Cancer Tumor Markers, |
|
|
|
|
|
|
|
Capsulorrhaphy
- Thermal |
|
Carbogen
(95% Oxygen, 5% Carbon Dioxide) Inhalation in Cancer Treatment |
|
Cardiac
Hemodynamic Monitoring for the Management of Heart Failure in the Outpatient
Setting |
|
Cardiac
Resynchronization Therapy (CRT) for Heart Failure |
|
Cardioblate® Closure Device |
|
CardioMEMS
EndoSure™ |
|
CardioSEAL®
- Transcatheter Closure Devices for Cardiac Defects |
|
CardioVAD™ |
|
Cardioverters, |
|
|
|
|
|
Carimune®
NF |
|
Carotid
Intima-Medial Thickness (CIMT), Ultrasonographic Measurements as an Assessment
of Subclinical Atherosclerosis |
|
Cavernosometry
and Cavernosography, Dynamic Infusion (DICC) for Erectile Dysfunction |
|
CDKN2A |
|
Celiac
Disease - Serologic Diagnosis |
|
CellSearch™ |
|
Cellular
Cardiomyoplasty |
|
Cerezyme® |
|
Certolizumab
Pegol |
|
Cervarix® |
|
Cervical
Cancer Screening Technologies (Pap/HPV/Speculoscopy/Cervicography) |
|
Cervical
Traction Devices for Home Use |
|
CervicographySM |
|
Cetuximab |
|
Chelation Therapy |
|
Chemical Endarterectomy |
|
Chemical Peels |
|
Chemoembolization
for the Treatment of Surgically Unresectable Hepatocellular Carcinoma |
|
Chemoresistance
Assays - In Vitro |
|
Chemosensitivity
Assays - In Vitro |
|
Chin Augmentation (Mentoplasty, Genioplasty) |
|
Chondrocyte
Implantation (ACI), Autologous |
|
Cimzia® |
|
Cinryze® |
|
Cineradiography |
|
Circulating
Tumor Cells in the Management of Individuals with Cancer |
|
Circulator
Boot System |
|
Clearlight™ |
|
Clinical
Preventive Services |
|
Coblation
Technology |
|
Cochlear Implant |
|
Cognitive
Rehabilitation |
|
Cold
Laser Therapy |
|
Collagen
Cross Links as Markers of Bone Turnover |
|
Collagen
Implantation for Urinary Incontinence |
|
Collagen
Meniscus Implants |
|
Collagenase
Clostridium Histolyticum for Dupuytren’s Contracture |
|
Colon
Cancer, Genetic Testing for Inherited Susceptibility |
|
Colonoscopy,
Screening for Colorectal Cancer in Individuals at Average Risk |
|
Colonoscopy,
Virtual (Computed Tomography Colonography) |
|
Color Ultrasonography Scan for Erectile Dysfunction |
|
Complementary
and Alternative Medicine |
|
Computed
Tomography Angiography for Coronary Artery Evaluation |
|
Computed
Tomography Colonography (Virtual Colonoscopy) |
|
Computed
Tomography to Detect Coronary Artery Calcification |
|
Computed Tomography
(CT) Perfusion Imaging |
|
Computed
Tomography (CT) Scanning for Lung Cancer Screening |
|
Computer
Assisted Surgical Navigational Orthopedic Procedures |
|
Computer-Aided
Detection of Malignancy with Magnetic Resonance Imaging of the Breast |
|
Computerized
2-lead Resting Electrocardiogram Analysis for the Diagnosis of Coronary
Artery Disease |
|
Conditioning
Play Audiometry for Hearing |
|
Condylotomy,
Modified for Treatment of Temporomandibular Joint (TMJ) Disorders |
|
Congenital,
Treatment of Port Wine Stains and Hemangiomas |
|
Congenital
Cardiac Channelopathies - Genetic Testing |
|
Conjunctival Challenge Test |
|
Continuous
Local Delivery of Analgesia to Operative Sites Using an Elastomeric Infusion
Pump |
|
Continuous
Monitoring of Glucose in the Interstitial Fluid |
|
Continuous Passive Motion
(CPM) Device in the Home Setting |
|
Cooling
Devices Used in the Outpatient Setting |
|
Cord
Blood Transplant for Hematopoietic Stem Cell Support |
|
Corneal
Endothelial Microscopy |
|
Corneal Topography/Computer-Assisted Photokeratoscopy |
|
Corporal Cavernosal Electromyography for Erectile Dysfunction |
|
CorRestore™
Patch System |
|
Corticotropin
Therapy |
|
Corus
CAD™ |
|
Cough
Machine |
|
Cranial
Electrotherapy Stimulation and Transcranial Magnetic Stimulation for the
Treatment of Depression and Other Psychiatric/Neurologic Disorders |
|
Cranial
Orthosis for the Treatment of Plagiocephaly |
|
Craniosacral
Therapy |
|
Crisantaspase |
|
Cryocuff® |
|
Cryosurgical
Ablation for the Treatment of Prostate Tumors |
|
Cryosurgical
Ablation for Treatment of Renal Tumors |
|
Cryosurgical
Ablation of Miscellaneous Solid Tumors |
|
CT Perfusion Imaging |
|
CT
Screening - Whole-Body |
|
Current
Perception Threshold Testing |
|
Cutaneous
Electrogastrography (EGG) |
|
CVProfilor™DO-2020 CardioVascular Profiling System |
|
CyberKnife® |
|
CYP2D6 |
|
Cystic Fibrosis, Genetic Testing |
|
Cytochrome p450 Genotyping |
|
Cytologic
Evaluation in Breast Cancer Risk Assessment |
|
Cytopathology |
|
Cytoreduction
and Hyperthermic Intraperitoneal Chemotherapy |
|
Cytotoxic Food Tests |
|
|
|
D |
|
|
|
Daily
Hemodialysis in the Home |
|
Darbepoetin
Alfa |
|
Deep
Brain Stimulation for the Treatment of Movement Disorders |
|
Defibrillators, |
|
|
|
|
|
Deflux® |
|
Degarelix
Acetate |
|
Denosumab |
|
Dermabrasion |
|
Detection
and Quantification of Circulating Tumor Cells in the Management of Individuals
with Cancer |
|
Diabetes, General Policy |
|
Diabetes Management |
|
Diagnostic
Endocardial Electrical Recording & Stimulation EES |
|
Diagnostic Labwork for Erectile Dysfunction |
|
Diagnostic
Spinal Ultrasound (Echography/Sonogram), Nonoperative |
|
Diapulse®
Wound Treatment System™ |
|
Digital
Breast Tomosynthesis |
|
Digital
Epiluminescence Microscopy for the Diagnosis of Skin Lesions |
|
Digital
Motion X-ray (DMX) |
|
DISC
Nucleoplasty™ |
|
Discectomy, Percutaneous |
|
Diseases
or Conditions of the Breast, General Policy |
|
DNA in Stool Samples as a Technique for Colorectal
Cancer Screening |
|
Donor
Lymphocyte Infusion for Hematologic Malignancies Treated with an Allogeneic
Hematopoietic Stem Cell Transplant |
|
Dorsal
(Posterior) Rhizotomy, Selective for Spasticity in Cerebral Palsy |
|
Drug-Eluting
Lung Stents for Emphysema |
|
Drug-Eluting
Stents for the Prevention and Management of Restenosis |
|
Ductal
Lavage for Cancer Risk Assessment |
|
Duplex Ultrasonography for Erectile Dysfunction |
|
Dynamic Infusion Cavernosometry and Cavernosography (DICC)
for Erectile Dysfunction |
|
Dynamic Posturography
in the Assessment of Balance |
|
Dynamic
Spinal Visualization |
|
Dynamic
Splinting |
|
Dynasplint® |
|
Dysport® |
|
|
|
E |
|
|
|
Echocardiography,
Fetal |
|
Echography, |
|
|
|
ECMO |
|
Eculizumab |
|
Elastomeric
Infusion Pump |
|
Electrical Bone Growth Stimulation |
|
Electrical
Impedance Scanning of the Breast |
|
Electrical
Nerve Stimulation, General Policy |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Electrocardiogram
Analysis for the Diagnosis of Coronary Artery Disease |
|
Electrocardiographic
Body Surface Mapping |
|
Electrocardiographic Monitoring, Transtelephonic |
|
Electrocardiography, Signal Averaged (SAECG) |
|
Electrocochleography
(ECochG) |
|
Electrocorticography
(ECoG) |
|
Electroencephalograms
(EEGs) by Telemedicine Transmission |
|
Electrogastrography
(EGG) |
|
Electrolysis, Removal of Hair |
|
Electromagnetic
Navigation Bronchoscopy |
|
Electromagnetic
Therapy for the Treatment of Wounds |
|
Electromyography (EMG),
Needle |
|
Electromyography
(sEMG), Surface |
|
Electromyography, Corporal Cavernosal for Erectile Dysfunction |
|
Electron Beam Computed Tomography (EBCT) - |
|
|
|
|
|
Electrophrenic Pacemaker |
|
Electrophysiologic Studies, Intracardiac |
|
Eligard® |
|
Embolectomy
for Treatment of Acute Stroke |
|
Emergency
Care |
|
End
Diastolic Pneumatic Compression Boot as a Treatment of Peripheral Vascular
Disease |
|
End-Stage Heart Failure, General Policy |
|
Endobronchial
Valves |
|
EndoCinch™ |
|
Endoluminal
Radiofrequency or Laser Ablation for Treatment of Varicose Veins |
|
Endometrial Ablation for Treatment of
Menorrhagia |
|
Endomyocardial
Biopsy, Post Heart Transplant |
|
Endoscopic
Injection Sclerotherapy for Treatment of Esophageal Varices |
|
Endoscopic
Surgery - Natural Orifice Transluminal |
|
Endothelial
Cell Photography |
|
Endothelial
Keratoplasty |
|
Endovascular
Stent Grafting for Treatment of Abdominal Aortic Aneurysm and Thoracic
Aortic Aneurysm and Dissections |
|
Enhanced
External Counterpulsation (EECP) |
|
Entecavir |
|
Enteral
Nutrition/Home Hyperalimentation |
|
Enterra™
Therapy Systems |
|
Enteryx™ |
|
Enuresis
Alarms |
|
Epidermal
Growth Factor Receptor (EGFR) Mutation Analysis for Individuals with Non-Small
Cell Lung Cancer (NSCLC) |
|
Epidural
Adhesiolysis for Chronic Pain Syndrome |
|
Epidural
Steroid Injections, Lumbar |
|
Epiluminescence
Microscopy, Digital for the Diagnosis of Skin Lesions |
|
Epiretinal
Radiation Therapy for Age-Related Macular Degeneration (ARMD) |
|
EpiVir®
HBV |
|
Epoetin
Alfa |
|
Epogen® |
|
Epoprostenol
Sodium for the Treatment of Pulmonary Hypertension |
|
Erbitux® |
|
Erectile Dysfunction, General Policy |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Eribulin
Mesylate |
|
Erwinaze™ |
|
Erythropoiesis-Stimulating
Agents (ESAs) |
|
EsophyX™ |
|
|
|
|
|
Essure™ |
|
Euflexxa® |
|
EVLT
(Endovenous Laser Therapy) |
|
Evoked Otoacoustic Emissions (OAE) |
|
Evoked
Potential Measurements for Erectile Dysfunction |
|
Evoked Potentials, |
|
|
|
|
|
|
|
ExAblate
2000 |
|
Excision or Treatment of Tattoos |
|
Exhaled
Breath Condensate in the Diagnosis and Management of Asthma and Other
Respiratory Disorders |
|
External
Penile Vacuum Constriction Devices for Erectile Dysfunction |
|
Extracorporeal
Immunoadsorption (ECI) Using Protein A Columns |
|
Extracorporeal
Membrane Oxygenation (ECMO) |
|
Extracorporeal
Photopheresis |
|
Extracorporeal
Shock Wave Therapy for Musculoskeletal Conditions |
|
Extracorporeal
Shock Wave Therapy in the Treatment of Peyronie's Disease |
|
Extraoperative Electrocorticography |
|
Eylea™ |
|
|
|
F |
|
|
|
Fabrazyme® |
|
Facelift,
Facial Thread Lift |
|
Facet
Arthroplasty |
|
Facet
Steroid Injections, Lumbar |
|
Facial
Thread Lift |
|
Factor IX |
|
Factor
VIIa (Recombinant) |
|
FAMILION™ |
|
Feather
Lift |
|
Fecal
Calprotectin Testing |
|
Fecal
Occult Blood Tests |
|
Fetal Echocardiography |
|
Fetal Fibronectin
(fFN) to Predict Preterm Labor |
|
Fetal
Surgery for Prenatally Diagnosed Malformations |
|
Filgrastim - Granulocyte Colony Stimulating Factors |
|
Firmagon® |
|
First-Trimester
Detection of Down Syndrome Using Fetal Ultrasound Markers Combined with
Maternal Serum Assessment |
|
Fistula
Plugs |
|
Flebogamma® |
|
Flolan® |
|
Folotyn® |
|
Fracture Healing Device, Ultrasound Accelerated |
|
Frenectomy
/ Frenuloplasty |
|
|
|
G |
|
|
|
Galsulfase (Systemic) |
|
Game
Ready™ Accelerated Recovery System |
|
Gamma
Knife |
|
Gammagard®
S/D / Gammagard®
Liquid |
|
Gamunex® |
|
Gardasil® |
|
Gastric Electrical Stimulation
for the Treatment of Gastroparesis and Obesity |
|
Gastrointestinal
Cancer, Serum Tumor Markers |
|
Gene
Expression Profiling Assays as a Technique to Determine Prognosis for
Managing Breast Cancer Treatment |
|
Gene
Expression Testing , Microarray-based for Cancers of Unknown
Primary |
|
Gene
Expression Testing for Coronary Artery Disease |
|
Gene-based
Tests for Screening, Detection, and/or Management of Prostate Cancer |
|
Genetic
Evaluation of Individuals with Developmental Delay/Mental Retardation |
|
Genetic Testing, |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Genetic
Variants to Predict Risk of Nonfamilial Breast Cancer |
|
Genioplasty (Mentoplasty) |
|
Genotyping - Cytochrome p450 |
|
Genotyping
for Chronic Hepatitis C |
|
Genotyping
for Predicting Cardiovascular Risk and/or Effectiveness of Statin Therapy |
|
GERD
- Transesophageal Endoscopic Therapies |
|
Germ
Cell Tumors - HSCT |
|
Glucose
Monitoring in the Interstitial Fluid |
|
GlucoWatch® |
|
Glycosylated Hemoglobin
A1c Screening |
|
Growth
Hormone Replacement Therapy |
|
Guide to Clinical
Preventive Services |
|
|
|
H |
|
|
|
H.P.
Acthar®
Gel |
|
Hair Removal |
|
Hair Transplantation |
|
Halaven® |
|
Hand
Held Oscillatory Positive Expiratory Pressure Devices |
|
Healon® / Healon5®
/ Healon GV® |
|
Hearing
Impairment, General Policy |
|
Heart
Mate® |
|
Heartsbreath |
|
Helicobacter
pylori Treatment - Genetic Testing |
|
Helium
Ion Beam (Charged Particle) Radiation Therapy |
|
Hemangiomas |
|
Hematopoietic
Stem-Cell Transplantation, Autologous for Malignant Astrocytomas and Gliomas |
|
Hematopoietic
Stem Cell Support - HDC |
|
Hematopoietic
Stem Cell Transplantation for Breast Cancer |
|
Hematopoietic
Stem-Cell Transplantation for Miscellaneous Solid Tumors in Adults |
|
Hematopoietic
Stem Cell Transplantation in the Treatment of Germ Cell Tumors |
|
Hematoporphyrin |
|
Hemodialysis
in the Home |
|
Hemoglobin A1c Screening,
Glycosylated |
|
HepaGam
B® |
|
Hepatitis
B Immune Globulin |
|
Hepsera® |
|
HER-2, Genetic Testing |
|
High
Dose Chemotherapy with Autologous Stem-Cell Transplant for Primary Amyloid
Light-Chain (AL) Amyloidosis |
|
High
Dose (Myeloablative) Chemotherapy with Bone Marrow, Peripheral Stem Cell,
or Cord Blood Transplant for Hematopoietic Stem Cell Support |
|
High
Dose Chemotherapy with Hematopoietic Stem Cell Support - Tandem |
|
High
Sensitivity C-Reactive Protein (hs-CRP) Testing for Cardiovascular Disease
(CVD) |
|
High-Density
Lipoprotein (HDL) Subclass Testing for Screening, Diagnosis and Management
of Dyslipidemia and Cardiovascular Disease |
|
Hip
Resurfacing |
|
Hippotherapy |
|
Home
Apnea Monitoring / Home Cardiorespiratory Monitoring |
|
Home Hyperalimentation (Total Parenteral/Enteral
Nutrition) |
|
Home Phototherapy for Neonatal Jaundice |
|
Home
Pulse Oximetry |
|
Home Spirometry |
|
Home
Uterine Activity Monitoring (HUAM) |
|
Home-based
Pulmonary Rehabilitation |
|
Homocysteine
Testing in the Screening, Diagnosis, and Management of Dyslipidemia and
Cardiovascular Disease |
|
HPV
(Human Papillomavirus) DNA Assay Test |
|
HPV Vaccine |
|
Human Epididymis
Protein 4 (HE4) |
|
Human
Growth Hormone Therapy |
|
Human Organ and Tissue Transplantation, General Policy |
|
Human
Papillomavirus (HPV) Vaccine |
|
Hyalgan® |
|
Hyaluronan Derivatives |
|
Hyperbaric
Oxygen Pressurization / Therapy (HBO2) |
|
HyperHEP B® |
|
Hypertension
Therapy Using Low Level Electrical Stimulation |
|
Hyperthermia
Therapy for Treatment of Cancer |
|
Hyperthermic
Intraperitoneal Chemotherapy |
|
Hypothermia, Total Body and Regional |
|
Hysteroscopic
Techniques for Permanent Sterilization |
|
|
|
I |
|
|
|
IBD
First Step™ |
|
IDET,
Intradiscal Electrothermal Annuloplasty |
|
IG-MILD
for Spinal Stenosis |
|
Ilaris® |
|
Ilizarov
Bone Lengthening Technique |
|
Image-Guided
Minimally Invasive Lumbar Decompression for Spinal Stenosis |
|
Imiglucerase |
|
Immunochemical
Fecal Occult Blood Tests |
|
Implant
Removal, Breast |
|
Implantable,
Automatic Cardioverter Defibrillator for the Prevention of Sudden Death |
|
Implants,
Palatal for the Treatment of Obstructive Sleep Apnea or Snoring |
|
ImPressure™ |
|
In
Vitro Chemosensitivity and Chemoresistance Assays |
|
In
Vitro Particle Size Measurement for Screening Hypersensitivity Reactions
to Foods and Chemicals |
|
In
Vivo Analysis of Colorectal Polyps |
|
In-Exsufflator,
Mechanical |
|
Inert
Gas Rebreathing Devices in the Outpatient Setting |
|
Infant
Home Apnea Monitoring / Home Cardiorespiratory Monitoring |
|
Infliximab |
|
Infusion
of Growth Factors |
|
Ingestible
pH and Pressure Capsule |
|
Ingestible
Video Capsule Imaging of the Gastrointestinal Tract |
|
Inherited Genetic Disorders, General Policy |
|
Inherited
Susceptibility to Colon Cancer, including Microsatellite Instability Testing,
Genetic Testing |
|
Injections, |
|
|
|
|
|
|
|
|
|
|
|
Insulin
Pumps - Diabetes Management |
|
Interferential
Current Stimulation for the Treatment of Pain |
|
Interferon
Alfa-2b |
|
Intermediate
Density Lipoproteins - Serum Measurement |
|
Internal
Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome |
|
Internal Penile
Prosthesis |
|
Internal Pudendal Arteriography (Angiography), Selective
for Erectile Dysfunction |
|
Interpositional
Spacer for the Treatment of Osteoarthritis |
|
Interspinous
Distraction Devices (Spacers) |
|
Interstitial
Fluid - Short-Term and Long-Term Continuous Glucose Monitoring |
|
Intracardiac Electrophysiologic Studies |
|
Intracavitary
Balloon Catheter Brachytherapy for Malignant Gliomas or Metastases to
the Brain |
|
Intracranial
Stent Placement |
|
Intracellular Micronutrient
Analysis |
|
Intradialytic
Parenteral Nutrition |
|
Intradiscal
Annuloplasty for the Treatment of Discogenic Back Pain |
|
Intradiscal,
Percutaneous Radiofrequency Thermocoagulation for the Treatment of Discogenic
Pain |
|
Intraepidermal
Nerve Fiber Density Testing |
|
Intraoperative
Neurophysiologic Monitoring |
|
Intraoperative Radiation Therapy (IORT) |
|
Intraoral
Devices for the Treatment of Headaches |
|
Intrapulmonary
Percussive Ventilation |
|
Intrastromal
Corneal Ring Segments (ICRS) for Vision Correction |
|
Intrauterine
Laser Ablation of Placental Vessels for Twin-to-Twin Transfusion Syndrome
(TTTS) |
|
Intrauterine
Myelomeningocele Repair |
|
Intravascular
Ultrasound (IVUS) Imaging of Coronary Arteries |
|
Intravenous Immune Globulin (IVIG) Therapy |
|
Intron®
A - Pharmaceutical Management of Chronic Hepatitis B |
|
Iontophoresis
for Medical Indications |
|
Ipilimumab |
|
Islet
Cell Transplantation, Pancreatic |
|
Isolated
Limb Perfusion/Infusion for Malignant Melanoma |
|
Istodax® |
|
IVIG |
|
|
|
|
|
|
|
IVUS |
|
|
|
J |
|
|
|
JAS™
Device |
|
Jaundice,
Home Phototherapy for Neonatal |
|
Jevtana® |
|
|
|
K |
|
|
|
Kerastick® |
|
Keratoplasty,
Endothelial |
|
Keratoprosthesis |
|
Ketogenic
Diet Counseling for Refractory Seizure Control |
|
KIF6
Genotyping for Predicting Cardiovascular Risk and/or Effectiveness of
Statin Therapy |
|
Krystexxa™ |
|
Kyphoplasty |
|
|
|
|
|
L |
|
|
|
Laboratory
Tests for Heart Transplant Rejection |
|
Lamivudine |
|
Language
/ Speech Therapy, Occupational Therapy and Physical Therapy for Autism |
|
Laronidase |
|
Laser
Ablation, Endoluminal for Treatment of Varicose Veins |
|
Laser
Assisted Myringotomy |
|
Laser Assisted Uvulopalatoplasty (LAUP) |
|
Laser
Device for Obtaining Blood Sample |
|
Laser
Photocoagulation Therapy |
|
Laser Surgery / Treatment, |
|
|
|
|
|
Laser
Therapy for the Treatment of Acne |
|
LASIK (laser in situ keratomileusis) |
|
Late
Lyme Disease, Testing and Treatment |
|
Left-Atrial
Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation |
|
Leukocyte Histamine Release Test (LHRT) |
|
Leukocyte
Infusion, Donor (DLI) for Hematologic Malignancies Treated with an Allogeneic
Hematopoietic Stem Cell Transplant |
|
Leuprolide Acetate |
|
Levulan® |
|
Light
Box Therapy (Phototherapy) for Seasonal Affective Disorder |
|
Light
Emitting Diode (LED) Therapy |
|
Linear-accelerator |
|
Lipectomy |
|
Lipid Apheresis
for the Treatment of Hypercholesterolemia |
|
Lipid
Risk Factors in Risk Assessment and Management of Cardiovascular Disease |
|
Lipoprotein(a)
Enzyme Immunoassay in the Management of Cardiovascular Disease |
|
Lipoprotein-Associated
Phospholipase A2 (Lp-PLA2) in the Assessment of Cardiovascular Risk |
|
Liposuction |
|
Liver
Assist Devices for the Treatment of Liver Conditions |
|
Local
or Whole Body Hyperthermia Therapy for Treatment of Cancer |
|
Low
Level Laser Therapy (LLLT) |
|
Low-Density
Lipid Apheresis |
|
Low-Density
Lipoprotein (LDL) Subclass Testing for Screening, Diagnosis and Management
of Dyslipidemia and Cardiovascular Disease |
|
Lp-PLA2
Measurement in the Assessment of Cardiovascular Risk |
|
Lumbar Discectomy,
Percutaneous |
|
Lumbar Steroid Injections, |
|
|
|
|
|
Lumizyme™ |
|
LUNA
for the Treatment of Chronic Pelvic Pain |
|
Lung
Stents for Emphysema- Drug-Eluting |
|
Lung
Volume Reduction Surgery for Severe Emphysema |
|
Lupron®, Lupron Depot® |
|
LVAD |
|
Lyme
Disease, Testing and Treatment |
|
Lymphedema Devices |
|
Lymphedema
Drainage (MLD), Manual |
|
Lymphocytic
Mitogen Response Assay for the Diagnosis of Vitamin, Mineral, and Antioxidant
Functional Deficiencies |
|
Lysis
of Epidural Adhesions for Chronic Pain Syndrome |
|
|
|
M |
|
|
|
Magnetic
Navigation Mapping System, 3-D |
|
Magnetic
Resonance Imaging (MRI) - Positional |
|
Magnetic
Resonance Imaging (MRI) of the Breast |
|
Magnetic
Source Imaging of the Brain |
|
Magnetoencephalography |
|
Mammaplasty
(Non-Cancerous), Breast Augmentation |
|
Mammaplasty
(Non-Cancerous), Reduction |
|
Mammography Screening |
|
Manipulation of Musculoskeletal
System Under Anesthesia |
|
Manipulation
Under Anesthesia, Spinal |
|
Manual
Lymphedema Drainage (MLD) |
|
Mapping,
Topographic Brain |
|
Mastectomy,
Prophylactic |
|
Mastectomy for Gynecomastia |
|
Measurement
of Exhaled Nitric Oxide and Exhaled Breath Condensate in the Diagnosis
and Management of Asthma and Other Respiratory Disorders |
|
Measurement
of Lipoprotein-Associated Phospholipase A2 (Lp-PLA2) in the Assessment
of Cardiovascular Risk |
|
Measurement
of Serum Intermediate Density Lipoproteins (Remnant Lipoproteins) |
|
Mechanical
Embolectomy for Treatment of Acute Stroke |
|
Mechanical
In-Exsufflator |
|
Mechanical Oscillometry |
|
Mechanical
Stretch Devices for the Treatment of Joint Stiffness |
|
Mechanized
Axial Spinal Distraction Therapy Devices |
|
Mediator
Release Test® |
|
Medical
Transport Services |
|
Medication
Assisted Treatment for Chemical Dependency |
|
Medullary Thyroid Carcinoma, Genetic Testing |
|
Melanoma
Vaccine, Active Specific Immunotherapy |
|
Melanomography |
|
Melaris® |
|
Meniett
Device |
|
Meniscal
Allografts and Collagen Meniscus Implants |
|
Mentoplasty (Chin Augmentation, Genioplasty) |
|
Methyl
Aminolevulinate Hydrochloride |
|
Metvixia® |
|
Microalbumin Screening
for Diabetic Nephropathy |
|
Microarray-based
Gene Expression Testing for Cancers of Unknown Primary |
|
Microprocessor-Controlled
Prostheses for the Lower Limb |
|
Microsatellite
Instability Testing |
|
Microscopy,
Corneal Endothelial |
|
Microscopy,
Digital Epiluminescence for the Diagnosis of Skin Lesions |
|
Microvolt
T-Wave Alternans Testing for Cardiac Arrhythmias |
|
Mini-Transplant
for Treatment of Malignancy |
|
Minimally
Invasive Coronary Artery Bypass Graft Surgery |
|
Minimally
Invasive Lumbar Decompression for Spinal Stenosis |
|
Minimed® |
|
Modified
Condylotomy for Treatment of Temporomandibular Joint (TMJ) Disorders |
|
Mole
Mapping |
|
Molecular
Anatomic Pathology Testing |
|
Monitors, |
|
|
|
|
|
|
|
|
|
Mononine® |
|
MRI-Guided
High Intensity Ultrasound Ablation of Uterine Fibroids |
|
Multi-gene
Expression Assay for Predicting Recurrence in Colon Cancer |
|
Multiple
Sclerosis, General Policy |
|
Multivisceral
Transplantation |
|
Music
Therapy for the Treatment of Neurologic Conditions / Diseases |
|
Myeloablative,
High Dose Chemotherapy with Bone Marrow, Peripheral Stem Cell, or Cord
Blood Transplant for Hematopoietic Stem Cell Support |
|
Myelomeningocele
Repair, Intrauterine |
|
Myobloc® |
|
Myocardial
Ablation, Percutaneous Transluminal Septal |
|
Myoelectric
Prosthetic Components for the Upper Limb |
|
Myozyme® |
|
Myringotomy,
Laser Assisted |
|
|
|
N |
|
|
|
Nabi-HB® |
|
Naglazyme® |
|
Nanosphere
Verigene Warfarin Metabolism Nucleic Acid Test |
|
Narrow
Band Imaging |
|
Nasal Challenge Test |
|
Nasal Function Studies |
|
Natalizumab |
|
Natural
Orifice Transluminal Endoscopic Surgery |
|
Navigational
Orthopedic Procedures |
|
NC-Stat® |
|
Nebulizer
Use in Home (Adult & Pediatric) |
|
Needle
Electromyography (EMG) |
|
Negative
Pressure Wound Therapy in the Outpatient Setting |
|
NeoVista
Epi-Rad90 System™ |
|
Nerve Conduction
Studies |
|
Nerve
Fiber Density Testing, Intraepidermal |
|
Nerve
Stimulation, Occipital |
|
Neulasta® |
|
Neupogen® |
|
NeuroCybernetic
Prosthesis® (Vagus Nerve Stimulator) |
|
Neurologic
Music Therapy |
|
Neurological
Disorders, Pain, Depression, and Nausea Diagnosed or Treated with Electrical
Nerve Stimulation, General Policy |
|
Neuromodulation
/ Stimulation for Pelvic Floor Dysfunction |
|
Neuromuscular
Electrical Stimulation |
|
Neuromuscular
Reeducation |
|
Neuropsychological Testing and Assessment
When
Performed by a Clinical Neuropsychologist |
|
Neutron
Capture Therapy, Boron (BNCT) for Glioblastoma Multiforme |
|
New-Fill® |
|
Nitric
Oxide Monitoring System (NIOX) |
|
Nocturnal Penile Tumescence (NPT) Testing |
|
Non-BRCA
Breast Cancer Risk Assessment |
|
Non-Contact
Ultrasound Treatment for Wounds |
|
Non-Invasive
Medical Devices for Measuring Arterial Elasticity for Cardiovascular Disease |
|
Non-Pharmacologic
Treatment of Rosacea |
|
Noncontact
Radiant Heat Wound Therapy Systems |
|
Nonfunctioning
or Absent Body Parts (Prosthetics), General Policy |
|
Nonmyeloablative
Allogeneic Stem Cell Transplantation (Reduced Intensity Stem Cell Transplant)
for Treatment of Malignancy |
|
Nonoperative
Diagnostic Spinal Ultrasound (Echography/Sonogram) |
|
Norditropin® |
|
NOTES |
|
NovoSeven®
/ NovoSeven® RT |
|
Nuchal
Translucency |
|
Nucleotome™ |
|
Nutritional
Treatment of Inborn Errors of Metabolism |
|
|
|
O |
|
|
|
Obesity, General Policy |
|
Obesity, Surgery for (Bariatric Surgery) |
|
Occipital
Nerve Stimulation |
|
Occlusion
of Uterine Arteries Using Transcatheter Embolization or Surgical Occlusion
for the Treatment of Fibroids |
|
Occupational
Therapy for Autism |
|
Ocular
Photoscreening in the Primary Care Physician's Office as a Screening Tool
to Detect Amblyogenic Factors |
|
Ofatumumab |
|
Omalizumab |
|
Oncotype
DX®
for Breast Cancer |
|
Oncotype
DX®
for Colon Cancer |
|
OncoVue® |
|
Oophorectomy,
Prophylactic |
|
Optometric
Vision Training/Orthoptics |
|
Oral
Appliances for Management of Mild to Moderate Obstructive Sleep Apnea
(OSA) |
|
Orencia® |
|
Organ
and Tissue Transplantation - Human, General Policy |
|
Orifice
Transluminal Endoscopic Surgery - Natural |
|
Orthognathic
Surgery |
|
Orthoptic
Training for the Treatment of Vision or Learning Disabilities |
|
Orthotics |
|
Orthovisc® |
|
Oscillating
Force Delivered Vertebral Adjustment in the Evaluation and Treatment of
the Spinal Column |
|
Oscillatory
Devices for the Treatment of Cystic Fibrosis |
|
Osteochondral
Allografting |
|
Osteochondral Autografting (OCG) |
|
Otoacoustic Emissions (OAE), Evoked |
|
Otoplasty |
|
Outpatient
Pulmonary Rehabilitation |
|
OVA1™ |
|
OvaCheck™ |
|
Ovarian
and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion
Syndrome |
|
Ovarian
Cancer Tumor Markers |
|
OvaSure™ |
|
Oviductal
Blocking |
|
Oxygen
Pressurization / Therapy, Hyperbaric (HBO2) |
|
Oxygenation
(ECMO), Extracorporeal Membrane |
|
|
|
P |
|
|
|
Pacemaker, |
|
|
|
|
|
Palatal
Implants for the Treatment of Obstructive Sleep Apnea or Snoring |
|
Palatopharyngoplasty (PPP) |
|
Palivizumab |
|
Pancreas/Pancreas-Kidney/Pancreatic
Islet Cell Transplantation |
|
Panitumumab |
|
Panniculectomy |
|
Pap Plus
SPECULOSCOPY® |
|
Pap Test,
ThinPrep® |
|
Papanicolaou
(Pap) Smear |
|
Partial
Knee Replacement |
|
Partial Left
Ventriculectomy for the Treatment of End-Stage Congestive Heart Failure
and Dilated Cardiomyopathy |
|
Patch Test and Photo Patch Test |
|
PathFinderTG® |
|
Pathwork® Tissue of
Origin Test |
|
Pegasys® - Pharmaceutical
Management of Hepatitis B |
|
Pegfilgrastim - Granulocyte Colony Stimulating Factors |
|
Peginterferon
Alfa-2a |
|
Pegloticase |
|
Pegvisomant |
|
Pelvic Floor Stimulation |
|
Pemetrexed |
|
Penile Brachial Index (PBI) |
|
Penile, External Vacuum Constriction Devices |
|
Penile, Internal
Prosthesis |
|
Penile, Nocturnal Tumescence (NPT) Testing |
|
Penile
Revascularization |
|
Penile
Venous Occlusive Procedure |
|
Percussion
/ Oscillating Devices for the Treatment of Respiratory Conditions |
|
Percutaneous
Disc Decompression Using Low-Temperature, Localized, Radiofrequency Energy |
|
Percutaneous
Discectomy |
|
Percutaneous
Electrical Nerve Stimulation (PENS) |
|
Percutaneous
Intradiscal Radiofrequency Thermocoagulation for the Treatment of Discogenic
Pain |
|
Percutaneous
LAA Closure Devices |
|
Percutaneous Testing (Scratch, Prick, or Puncture) |
|
Percutaneous Transluminal Angioplasty, |
|
|
|
|
|
Percutaneous
Transluminal Septal Myocardial Ablation |
|
Percutaneous
Vertebroplasty, Kyphoplasty and Sacroplasty |
|
Peripheral
Stem Cell Transplant |
|
Periureteral
Bulking Agents as a Treatment of Vesicoureteral Reflux (VUR) |
|
Periurethral
Bulking Agents for Stress Urinary Incontinence |
|
pH
and Pressure Capsule |
|
Pharmaceutical
Management of Chronic Hepatitis B |
|
Pharmacological Response Test (PRT) for Erectile Dysfunction |
|
Phenylketonuria (PKU)
Formula |
|
PhiCal™ |
|
Phonophoresis
for Medical Indications |
|
Photochemotherapy,
Extracorporeal |
|
Photodynamic
Therapy (PDT) for Dermatologic Conditions |
|
Photodynamic Therapy (PDT) for the Treatment
of Cancer, including Barrett's Esophagus |
|
Phototherapy
for the Treatment of Skin Disorders |
|
Photokeratoscopy, Computer-Assisted |
|
Photopheresis,
Extracorporeal |
|
Phototherapy, Home for Neonatal Jaundice |
|
Phototherapy,
Light Box Therapy for Seasonal Affective Disorder |
|
Physical
Therapy for Autism |
|
Physician Attendance at Delivery for Newborn Care |
|
Piezoelectric
Sensor Analysis and Oscillating Force Delivered Vertebral Adjustment in
the Evaluation and Treatment of the Spinal Column |
|
Placental
Blood Transplant |
|
Plasma
Exchange |
|
Platelet
Rich Plasma as a Treatment for Wound Healing or Other Conditions |
|
Plethysmography |
|
Plugs
for Fistula Repair |
|
Pneumatic
Compression Devices for Vascular Diseases |
|
Polar
Care Cub |
|
Poly-L-Lactic
Acid Injectable Implant Device |
|
Port Wine Stains, Treatment of Congenital |
|
Positional
Magnetic Resonance Imaging (MRI) |
|
Positron
Emission Mammography |
|
Positron
Emission Tomography (PET), |
|
|
|
|
|
Post Heart Transplant Endomyocardial Biopsy |
|
Posterior
Rhizotomy, Selective Dorsal for Spasticity in Cerebral Palsy |
|
Posterior
Tibial Nerve Stimulation (PTNS) for Voiding Dysfunction |
|
Pralatrexate |
|
Presacral
Neurectomy (PSN) for Treatment of Chronic Pelvic Pain |
|
Pressure
Sensors - Wireless |
|
Pressure-specified
Sensory Device Testing |
|
Privigen® |
|
Pro-Adjuster® |
|
Procrit® |
|
Profilnine®
SD |
|
Progenitor
Cell Therapy for the Treatment of Damaged Myocardium Due to Ischemia |
|
Prolastin® |
|
Prolia® |
|
Prolotherapy for
Musculoskeletal Disorders |
|
Prophylactic
Mastectomy |
|
Prophylactic
Oophorectomy |
|
Prostascint® |
|
Prostate Specific Antigen (PSA) |
|
Prosthetic
Intervertebral Disc |
|
Prosthetics
- Absent or Nonfunctioning Body Parts, General Policy |
|
Protein
Immunoadsorption Therapy |
|
Proteomics-based
Testing for the Evaluation of Ovarian (Adnexal) Masses |
|
Proton
Beam Radiosurgery |
|
Proton
or Helium Ion Beam (Charged Particle) Radiation Therapy |
|
PROVANT®
Wound Closure System |
|
Provenge® |
|
ProVisc® |
|
Provocative
and Neutralization Therapy for Food Allergies |
|
Provocative
Tests for Food or Food Additives and Food Challenge Testing |
|
PTNS
for Voiding Dysfunction |
|
Pulmonary Rehabilitation |
|
Pulse Oximetry,
Home |
|
Pure-Tone Audiometry |
|
PUVA
(Psoralens with Ultraviolet A) Therapy |
|
|
|
Q |
|
|
|
Quantification
and Detection of Circulating Tumor Cells in the Management of Individuals
with Cancer |
|
Quantitative
Sensory Testing |
|
|
|
R |
|
|
|
Radiation Therapy (IORT), Intraoperative |
|
Radioembolization
for Primary Tumors of the Liver and Metastatic Tumors to the Liver |
|
Radiofrequency,
Endoluminal Ablation for Treatment of Varicose Veins |
|
Radiofrequency
Ablation for Barrett’s Esophagus |
|
Radiofrequency
Ablation for Treatment of Tumors |
|
Radiofrequency
Energy Transanal Treatment of Fecal Incontinence |
|
Radiofrequency
Tissue Volume Reduction (RFTVR) for the Treatment of Upper Airway Obstruction |
|
Radioimmunoscintigraphy
Imaging (Monoclonal Antibody Imaging) with Indium-111 Capromab Pendetide
for Prostate Cancer |
|
Radionics® |
|
Radiosurgery
- Stereotactic |
|
Radiotherapeutics® |
|
Radiotherapy
for Prostate Cancer |
|
Reclast® |
|
Reduced
Intensity Stem Cell Transplant for Treatment of Malignancy |
|
Reduction
Mammaplasty (Non-Cancerous) |
|
Rehabilitation, |
|
|
|
|
|
Rejection,
Laboratory Tests for Heart Transplant |
|
Relieva® |
|
Remicade® |
|
Remnant
Lipoproteins |
|
Remodulin® |
|
Removal,
Breast Implant |
|
Removal, Hair |
|
Repositioning,
Canalith for Benign Paroxysmal Positional Vertigo (BPPV) |
|
Repository Emulsion Therapy |
|
RespiGam® |
|
Response Studies |
|
Restoration,
Surgical Ventricular |
|
Restorative
Obesity Surgery, Endolumenal |
|
Resurfacing,
Shoulder |
|
Resynchronization
Therapy, Cardiac (CRT) for Heart Failure |
|
Retinal Prosthesis |
|
Retinal
Telescreening for Diabetic Retinopathy |
|
Reverse
Shoulder Arthroplasty |
|
Rheos™ Baroreflex
Hypertension Therapy™
System |
|
Rhinomanometry and Acoustic Rhinometry |
|
Rhinoplasty |
|
Rhizotomy,
Selective Dorsal (Posterior) for Spasticity in Cerebral Palsy |
|
Rh0(D)
Immune Globulin |
|
Rhophylac® |
|
Rilonacept |
|
RITA®
- Radiofrequency Interstitial Tissue Ablation |
|
Rituximab (Systemic) |
|
ROSE |
|
Rotavirus Vaccine (RotaTeq®, Rotarix®) |
|
RTube |
|
Rufinamide |
|
|
|
S |
|
|
|
Sacral
Nerve Stimulation for Urinary Incontinence |
|
Sacral
Nerve Neuromodulation / Stimulation for Pelvic Floor Dysfunction |
|
Sacroiliac
Joint Arthrography and Injection |
|
Sacroplasty |
|
Saliva Testing for Hormone
Levels |
|
Saturation
Biopsy for Diagnosis and Staging of Prostate Cancer |
|
SAVER |
|
Sclerotherapy,
Endoscopic Injection for Treatment of Esophageal Varices |
|
Sclerotherapy,
Varicose Vein Treatments |
|
Screening,
Cancer of the Cervix |
|
Screening
Colonoscopy for Colorectal Cancer in Individuals at Average Risk |
|
Sculptra™ |
|
Secca™
System |
|
Seed
Implantation, Radioactive |
|
Select Picture Audiometry |
|
Selective
Dorsal (Posterior) Rhizotomy for Spasticity in Cerebral Palsy |
|
Selective Internal Pudendal Arteriography (Angiography)
for Erectile Dysfunction |
|
Selective
Internal Radiation Therapy (SIRT) via Microspheres for Primary and Metastatic
Tumors of the Liver |
|
Sensory
Evoked Potentials (SEP) |
|
Septal
Myocardial Ablation, Percutaneous Transluminal |
|
Serologic
Diagnosis of Celiac Disease |
|
Serostim® |
|
Serum
Antibodies for the Diagnosis and Management of Inflammatory Bowel Disease:
ANCA for Ulcerative Colitis and ASCA for Crohn's Disease |
|
Serum
Biomarker Human Epididymis Protein 4 (HE4) |
|
Serum
Holotranscobalamin as a Marker of Vitamin B12 (Cobalamin) Status |
|
Serum
Tumor Markers for Breast Malignancies |
|
Serum
Tumor Markers for Gastrointestinal Cancer |
|
Short-Term
and Long-Term Continuous Glucose Monitoring of the Interstitial Fluid |
|
Shoulder
Arthrography |
|
Shoulder
Arthroplasty, Reverse |
|
Shoulder
Resurfacing |
|
Signal
Averaged Electrocardiography (SAECG) |
|
Single
Nucleotide Polymorphisms - SNP's |
|
Sipuleucel-T |
|
SIR-Spheres® |
|
Sleep
Apnea, General Policy |
|
Sleep Disorder Studies |
|
Small
Bowel/Small Bowel-Liver/Multivisceral Transplantation |
|
SmartPill® GI Monitoring
System |
|
Soliris® |
|
Somatosensory
Evoked Potentials (Non-intraoperative) |
|
Somavert® |
|
Somnoplasty |
|
Sonogram
- Nonoperative Diagnostic Spinal Ultrasound (Echography) |
|
Specific IgE In Vitro Tests (RAST, MAST & FAST) |
|
Specular
Microscopy |
|
Speech
/ Language Therapy, Occupational Therapy and Physical Therapy for Autism |
|
Spinal
Cord Stimulation for Treatment of Pain |
|
Spinal
Manipulation Under Anesthesia |
|
Spinal
Ultrasound, Nonoperative Diagnostic (Echography/Sonogram) |
|
Spinal
Unloading Devices for the Treatment of Low Back Pain |
|
Spinal
Visualization, Dynamic |
|
Spirometry -
Home |
|
SporTX
Stimulator |
|
Staff
Practitioners to Whom Services May Be Delegated |
|
Staff
Supervision Requirements for Delegated Services |
|
Standby Physician at Delivery |
|
Stelara™ |
|
Stem
Cell Therapy for Peripheral Artery Disease |
|
Stem
Cell Transplant |
|
Stereotactic
Radiosurgery of Central Nervous System (CNS) Lesions |
|
Steroid Injections - Lumbar, |
|
|
|
|
|
Stimulation, Pelvic Floor |
|
StomaphyX |
|
Stretta™ |
|
Sublingual Immunotherapy |
|
Supartz® |
|
Suprachoroidal
Delivery of Pharmacologic Agents |
|
Sural
Nerve Graft in Association with Radical Prostatectomy |
|
Surface
Electromyography (sEMG) |
|
Surgery for Morbid Obesity (Bariatric Surgery) |
|
Surgical
Interruption of Pelvic Nerve Pathways for the Treatment of Chronic Pelvic
Pain |
|
Surgical
Occlusion for the Treatment of Fibroids |
|
Surgical
Ventricular Restoration |
|
Symmetry Surgery Following Mastectomy |
|
Sympathetic
Therapy for the Treatment of Pain |
|
Synagis® |
|
Synvisc® / Synvisc-One® |
|
Systemic
Thermotherapy |
|
|
|
T |
|
|
|
T-Wave
Alternans Testing for Cardiac Arrhythmias |
|
TACE |
|
Tamoxifen
Treatment, Genetic Testing |
|
Tandem
High Dose Chemotherapy with Hematopoietic Stem Cell Support |
|
Targeted
Phototherapy (UVB Therapies) |
|
Tattoos, Excision or Treatment |
|
Teflon®
Injections |
|
Telangiectasia |
|
Telbivudine |
|
Telemedicine/ Telehealth |
|
Telemedicine
Transmission of Electroencephalograms (EEGs) |
|
Teleradiology/
Teleimaging |
|
Temodar® |
|
Temozolomide |
|
Temporomandibular
Joint (TMJ) Arthroscopy |
|
Temporomandibular Joint (TMJ) Disorders, General Policy |
|
Tenofovir
disoproxil fumarate |
|
Testing and Treatment for Lyme Disease |
|
ThAIRapy®
Vest (Bronchial Drainage System) |
|
TheraSpheres® |
|
Thermal
Shrinkage as a Treatment of Joint Instability |
|
Thermography |
|
Thermotherapy,
Transpupillary (TTT) |
|
Thermotherapy,
Water-Induced (WIT) for the Treatment of Benign Prostatic Hypertrophy |
|
ThinPrep®
Pap Test |
|
Thoracic
Aortic Aneurysm and Dissections, Endovascular Stent Graftings |
|
Thoracic
Electrical Bioimpedance and Inert Gas Rebreathing Devices in the Outpatient
Setting |
|
Thoracic Sympathectomy for the Treatment of Hyperhidrosis |
|
Thread
Lift |
|
Three-Dimensional
Magnetic Navigation Mapping System for Radiofrequency Ablation for the
Treatment of Arrhythmias |
|
Thyroidectomy
for the Prevention of Medullary Thyroid Carcinoma |
|
Tinnitus
Retraining Therapy (TRT) and Tinnitus Maskers for the Treatment of Tinnitus |
|
TMJ Arthroscopy |
|
Tocilizumab |
|
Tomosynthesis,
Digital Breast |
|
Topographic Brain Mapping |
|
Tositumomab |
|
Total Ankle Replacement |
|
Total
Artificial Hearts (TAH) |
|
Total Body and Regional Hypothermia |
|
Total
Facet Arthroplasty |
|
Total
Hip Resurfacing |
|
Total Parenteral/Enteral Nutrition |
|
TR3ISVR™ Surgical Ventricular Restoration
System |
|
Transcatheter
Closure Devices for Cardiac Defects |
|
Transcatheter
Hepatic Arterial Chemoembolization |
|
Transciliary
Fistulization for the Treatment of Glaucoma |
|
Transcranial
Magnetic Stimulation for the Treatment of Depression and Other Psychiatric/Neurologic
Disorders |
|
Transcutaneous
Electrical Nerve Stimulation (TENS) |
|
Transcutaneous
Electrical Nerve Stimulation (TENS) for the Treatment of Nausea and Vomiting |
|
Transesophageal
Endoscopic Therapies for Gastroesophageal Reflux Disease (GERD) |
|
Transluminal, Percutaneous Angioplasty of Aortic Arch Vessels with or without stenting (Brachiocephalic, Carotid, Subclavian, & Vertebral arteries), and of Coarctation of the Aorta |
|
Transluminal
Angioplasty, Percutaneous of Intracranial Atherosclerotic Stenoses With
or Without Stenting |
|
Transluminal
Endoscopic Surgery - Natural Orifice |
|
Transluminal
Septal Myocardial Ablation, Percutaneous |
|
Transoral
NOTES |
|
Transplantation, Human Organ and Tissue, General Policy |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Transport
Services, Ambulance and Medical |
|
Transpupillary
Thermotherapy (TTT) |
|
Transtelephonic Electrocardiographic Monitoring |
|
Transtympanic
Micropressure Applications as a Treatment of Ménière's Disease |
|
Transvaginal
and Transurethral Radiofrequency Tissue Remodeling for Urinary Stress
Incontinence |
|
Treanda® |
|
Treatment
for Lyme Disease |
|
Treatment
of Congenital Port Wine Stains and Hemangiomas |
|
Treatment
of Germ Cell Tumors - HSCT |
|
Treatments
of Twin-to-Twin Transfusion Syndrome (TTTS) |
|
Treprostinil
for the Treatment of Pulmonary Hypertension |
|
Tubal
Occlusion |
|
Tumor Markers, |
|
|
|
|
|
|
|
Twin-to-Twin
Transfusion Syndrome (TTTS) |
|
Tysabri® |
|
Tyvaso® |
|
Tyzeka® |
|
|
|
U |
|
|
|
Ultrafast CT - |
|
|
|
|
|
Ultrasonographic
Measurements of Carotid Intima-Medial Thickness (CIMT) as an Assessment
of Subclinical Atherosclerosis |
|
Ultrasound, |
|
|
|
|
|
|
|
|
|
Umbilical
Cord or Placental Blood Transplant |
|
Unicompartmental
Knee Replacement |
|
Unicondylar
Interpositional Spacer for the Treatment of Osteoarthritis |
|
Unloading
Devices, Spinal for the Treatment of Low Back Pain |
|
Urethral
Bulking Agents for Stress Urinary Incontinence |
|
Urine-Based
HIV-1 Testing System |
|
Use
of Common Genetic Variants to Predict Risk of Nonfamilial Breast Cancer |
|
Ustekinumab |
|
Uterine
Activity Monitoring, Home (HUAM) |
|
Uterine
Arteries, Occlusion Using Transcatheter Embolization or Surgical Occlusion
for the Treatment of Fibroids |
|
Uterine Nerve Ablation for the Treatment of Chronic Pelvic Pain |
|
UVB
Therapies |
|
Uvulopalatopharyngoplasty
(UPPP)/Palatopharyngoplasty (PPP) |
|
|
|
V |
|
|
|
Vacuum
Assisted Closure for Wound Healing |
|
Vacuum Constriction Devices, External Penile |
|
Vagus
Nerve Stimulation for the Treatment of Depression |
|
Vagus
Nerve Stimulation for the Treatment of Medically Refractory Movement Disorders,
Headaches and Obesity |
|
Varicose
Vein Treatments for the Lower Extremities |
|
VAX-D® |
|
Vectibix® |
|
Velaglucerase
Alfa |
|
Velcade® |
|
Veletri® |
|
Venous Occlusive Procedure, Penile |
|
Ventricular
Assist Devices (VAD) and Total Artificial Hearts (TAH) |
|
Ventricular
Restoration, Surgical |
|
Vertebral
Axial Decompression |
|
Vertebroplasty,
Percutaneous |
|
Vesicoureteral
Reflux (VUR) |
|
Vidaza® |
|
Video
Capsule Imaging of the Gastrointestinal Tract, Ingestible |
|
Videofluoroscopy |
|
Viread® |
|
Virtual
Colonoscopy (Computed Tomography Colonography) |
|
Vision
Therapy |
|
Visual
Evoked Potentials |
|
Visual
Impairment Screening for Medical Diseases or Injury |
|
Visual Reinforcement Audiometry (VRA) for Hearing |
|
VNUS®
Closure™ System |
|
Vpriv™ |
|
Vulvectomy |
|
|
|
W |
|
|
|
Warfarin
Dose, Genetic Testing |
|
Warm-Up™
Active Wound Therapy |
|
WATCHMAN® Left-Atrial
Appendage Closure Devices |
|
Water-Induced
Thermotherapy (WIT) for the Treatment of Benign Prostatic Hypertrophy |
|
WCD
- Wearable Cardioverter Defibrillator for the Prevention of Sudden Death |
|
Wearable
Cardioverter Defibrillator for the Prevention of Sudden Death |
|
Whole
Body Hyperthermia Therapy for Treatment of Cancer |
|
Whole-Body
Computerized Axial Tomography (CT) Screening |
|
WinRho® |
|
Wireless
Pressure Sensors in Endovascular Aneurysm Repair |
|
Wound Therapy, |
|
|
|
|
|
|
|
X |
|
|
|
X-Stop® |
|
Xgeva® |
|
Xiaflex™ |
|
Xolair® |
|
|
|
Y |
|
|
|
Yervoy™ |
|
|
|
Z |
|
|
|
Zemaira® |
|
Zoledronic Acid |
|
Zometa® |
|
Zorbtive® |
|
Zostavax® |
|
Zoster Vaccine, Live |
|
|