Medical policies for providers

See the latest updates to our medical policies. 

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A B C D E F G H I J K L M N O P Q R S T U V W 

F

MP283-Facet Injections

MP231-Facet or Sacroiliac Joint Denervation
Radiofrequency (RF) facet and/or sacroiliac joint denervation is a percutaneous procedure in which sensory afferent nerve fibers are selectively destroyed by heat produced by radio waves delivered through an electrode. The objective is to eliminate ...

MP290-Fecal Microbiota Transplantation
Fecal microbiota transplantation is the transplantation of fecal bacteria from a healthy donor into the gastrointestinal tract of a recipient for the treatment of recurrent Clostridium difficile (C. difficile) infection.

MP059-Fetal Surgery
Fetal surgery involves opening the uterus (either by traditional cesarean surgical incision or through single or multiple fetoscopic port incisions), surgically correcting a fetal abnormality, then returning the fetus to the uterus and closing the uter...

MP34-Foot Orthotics
A depth shoe is one that: 1) has a full length, heel-to-toe filler that when removed, provides a minimum of 3/16" of additional depth used to accommodate custom-molded or customized inserts; 2) is made from leather or other suita...

MP223-Functional Anesthetic Discography
Functional anesthetic discography (FAD) is a diagnostic procedure that involves injecting an anesthetic agent directly into a spinal disc. During this procedure, under light sedation and x-ray guidance, a small catheter is inserted into the suspected d...


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