Medical policies

Evidence Based Guidelines - Alphabetical Index

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A   top

Ambulatory Blood Pressure Monitoring
Apnea Monitor for Use in the Home
Arthroscopic Debridement and Lavage as Treatment of Knee Osteoarthritis
Auditory Brain Stem Implant
Automated Nerve Conduction Tests

B   top

Bevacizumab in Advanced Adenocarcinoma of the Pancreas
BCR-ABL1 Testing for Diagnosis, Monitoring, and Drug Resistance Mutation Detection in Chronic Myelogenous Leukemia
Biochemical Markers of Alzheimer's Disease
Biventricular Pacemakers/Cardiac Resynchronization Therapy for Heart Failure
Blood Glucose Monitors for Use in the Home
Bone Turnover Markers for the Diagnosis and Management of Osteoporosis and Diseases Associated with High Bone

C   top

Cardiac Rehabilitation
Charged Particle Radiotherapy
Cryoablation of Prostate Cancer

D   top

Deep Brain Stimulation
Diabetic Retinopathy Telescreening
Diagnosis and Treatment of Sacroiliac Joint Pain
Donor Lymphocyte Infusion
Dynamic Spinal Visualization

E   top

Endobronchial Brachytherapy
Endoscopic Radiofrequency Ablation or Cryoablation for Barrett's Esophagus
Endovascular Stent Grafts for Abdominal Aortic Aneurysm
Endovascular Stent Grafts for Thoracic Aortic Aneurysm

Erythropoiesis-Stimulating Agents (ESAs)
External Insulin Pumps

F   top

Fecal Calprotectin Test

G   top

Genetic Testing for Duchenne and Becker Muscular Dystrophy
Genetic Testing for PTEN Hamartoma Tumor Syndrome
Glaucoma, Evaluation by Ophthalmic Techniques

H   top

Homocysteine Testing in Cardiac Disease Risk Assessment

I   top

Implantable Infusion Pumps
Inhaled Nitric Oxide
Interventions for Progressive Scoliosis
Intra Articular Hyaluronan Injections for Osteoarthritis of the Knee
Intravitreal Angiogenesis Inhibitors for Choroidal and Retinal Vascular Conditions
Intraoperative Radiation Therapy
Intraoperative Neurophysiologic Monitoring (sensory-evoked potentials, motor-evoked potentials, EEG monitoring)
Intrauterine Ablation or Resection of the Endometrium

J   top

None

K   top

KRAS and BRAF Mutation Analysis in Cancer

L   top

Laboratory Testing for HIV Tropism
Laser Assisted Tonsillectomy
Low Density Lipid Apheresis

M   top

Maternal and Fetal Diagnostics
Maze Procedure for Atrial Fibrillation or Flutter
Monitored Anesthesia Care (MAC)
Monoclonal Antibodies for Non-Hodgkin Lymphoma and Acute Myeloid Leukemia

N   top



O   top

None

P   top

Paraspinal Surface Electromyography
Pertuzumab for Treatment of HER2-Positive Malignancies
Pharmacogenomic and Metabolite Markers for Treatment with Thiopurines
Photodynamic Therapy for Treatment of Specific Cancers
Photodynamic Therapy Ocular
Prostate Cancer Treatment with Brachytherapy
Prothrombin Time Monitoring In The Home
Psychoanalysis
Pulmonary Rehabilitation

Q   top

Quantitative Sensory Testing

R   top

Radiofrequency Ablation of Primary or Metastatic Liver Tumors
Radioimmunotherapy in the Treatment of Non-Hodgkin Lymphoma

S   top

Screening for Vertebral Fracture with Dual X-Ray Absorptiometry (DEXA)
Septoplasty
Serum Biomarker Human Epididymis Protein 4 (HE4)

T   top

TENS (Transcutaneous Electrical Nerve Stimulator)
Therapeutic Apheresis
Thermography
Total Body Photography
Transmyocardial Revascularization (TMR)
Transpupillary Thermotherapy for Treatment of Choroidal Neovascular Conditions
Transurethral Microwave Thermotherapy for Benign Prostatic Hyperplasia
Trastuzumab

U   top

Ultrafiltration in Decompensated Heart Failure
Uterine Artery Occlusion in the Treatment of Uterine Fibroids

V   top

Ventricular Assist Devices and Total Artificial Hearts
Vertical Expandable Prosthetic Titanium Rib

W   top

None

X   top

None

Y   top

None

Z   top

None

 

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