Medical Policies

Evidence Based Guidelines - Categorical Index

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Administrative |  Drugs |  Home Health/Durable Medical Equipment |  Medical |  Mental Health/Chemical Dependency |  OB−GYN Reproduction |  Radiology |  Surgery |  Therapy |  Other Treatments

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Administrative   top


Drugs   top

Ado-Trastuzumab Emtansine (Trastuzumab-DM1) for Treatment of HER-2 Positive Malignancies
Erythropoiesis-Stimulating Agents (ESAs)

Home Health/Durable Medical Equipment   top

Photodynamic Therapy Ocular

Medical   top

Ambulatory Blood Pressure Monitoring
Bevacizumab in Advanced Adenocarcinoma of the Pancreas
Diagnosis and Treatment of Sacroiliac Joint Pain
Fecal Analysis in the Diagnosis of Intestinal Dysbiosis
Fecal Calprotectin Test
Genetic Testing for Alpha Thalassemia
Genetic Testing for CHARGE Syndrome
Genetic Testing for Duchenne and Becker Muscular Dystrophy
Genetic Testing for Facioscapulohumeral Muscular Dystrophy
Genetic Testing for Li-Fraumeni Syndrome
Genetic Testing for Hereditary Hearing Loss
Genetic Testing for PTEN Hamartoma Tumor Syndrome
KRAS and BRAF Mutation Analysis in Cancer
Paraspinal Surface Electromyography (EMG)
Radiofrequency Ablation of Primary or Metastatic Liver Tumors
Total Body Photography

Mental Health/Chemical Dependency   top


OB-GYN Reproduction   top

Intrauterine Ablation or Resection of the Endometrium 
Maternal and Fetal Diagnostics

Radiology   top

Endobronchial Ultrasound for Diagnosis and Staging of Lung Cancer

Surgery   top

Endovascular Stent Graft for Abdominal Aortic Aneurysm
Endovascular Stent Graft for Thoracic Aortic Aneurysm
Maze Procedure for Atrial Fibrillation or Flutter

Therapy   top

Transurethral Microwave Thermotherapy for Benign Prostatic Hyperplasia

Other Treatments   top

Glaucoma, Evaluation by Ophthalmic Techniques