Medical policies for providers
See the latest updates to our medical policies.
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.
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...
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...
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Clinical guidelines offer providers consistent and appropriate guidance for diagnosis and treatment of specific conditions or diseases.
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