Historical Medical Policies and Clinical UM Guidelines

Historical Medical Policies

 

Medical policies contained within this page are historical and not the most current versions. Current medical policy content may be accessed from the Medical Policies and Clinical UM Guidelines page. Publish dates of the most current version vary per state notification requirements.

 

 

DME.00011 Electrical Stimulation as a Treatment for Pain and Related Conditions: Surface and Percutaneous Devices

 

LAB.00019 Proprietary Algorithms for Liver Fibrosis

 

SURG.00129 Oral, Pharyngeal and Maxillofacial Surgical Treatment for Obstructive Sleep Apnea or Snoring

Historical Clinical UM Guidelines

 

Clinical UM guidelines contained within this page are historical and not the most current versions. Current clinical UM guideline content may be accessed from the Medical Policies and Clinical UM Guidelines page. Effective dates of the most current version vary per state notification requirements.

 

 

CG-DME-37 Air Conduction Hearing Aids