A-G |
H-P |
Q-Z |
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Acupuncture (PDF)
Effective Date: 1/1/2022 |
H Pylori Testing (PDF)
Effective Date: 1/1/2022 |
Radial Head Implant (PDF)
Effective Date: 1/1/2022 |
ADHD Assessment and Treatment (PDF)
Effective Date: 1/1/2022 |
Heart-Lung Transplant (PDF)
Effective Date: 1/1/2022 |
Radiofrequency Ablation of Uterine Fibroids (PDF)
Effective Date: 1/1/2022 |
Air Ambulance
Effective Date: 1/1/2022 |
Holter Monitors (PDF)
Effective Date: 1/1/2022 |
Reduction mammoplasty and gynecomastia surgery (PDF)
Effective Date: 1/1/2022 |
Allergy Testing (PDF)
Effective Date: 1/1/2022 |
Home Birth (PDF)
Effective Date: 1/1/2022 |
Repair of Nasal Valve Compromise (PDF)
Effective Date: 1/1/2022 |
Allogeneic hematopoietic cell transplants for sickle cell anemia and beta-thalassemia (PDF)
Effective Date: 1/1/2022 |
Home phototherapy for neonatal hyperbilirubinemia (PDF)
Effective Date: 1/1/2022 |
Robotic Surgery (PDF)
Effective Date: 1/1/2022 |
Ambulatory EEG (PDF)
Effective Date: 1/1/2022 |
Homocysteine Testing (PDF)
Effective Date: 1/1/2022 |
Sacroiliac joint fusion (PDF)
Effective Date: 1/1/2022 |
Ambulatory Surgery Center Optimization (PDF)
Effective Date: 1/1/2022 |
Hospice Services (PDF)
Effective Date: 1/1/2022 |
Sacroiliac Joint Interventions for Pain Management (PDF)
Effective Date: 1/1/2022 |
Antithrombin III (Thrombate III, Atryn) (PDF)
Effective Date: 1/1/2022 |
Hyperemesis gravidarum treatment (PDF)
Effective Date: 1/1/2022 |
Sclerotherapy and Chemical Endovenous Ablation for Varicose Veins (PDF)
Effective Date: 1/1/2022 |
Articular Cartilage Defect Repairs (PDF)
Effective Date: 1/1/2022 |
Hyperhidrosis treatments (PDF)
Effective Date: 1/1/2022 |
Selective Dorsal Rhizotomy (PDF)
Effective Date: 1/1/2022 |
Assisted Reproductive Technology (PDF)
Effective Date: 1/1/2022 |
Implantable Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea (PDF)
Effective Date: 1/1/2022 |
Selective Nerve Root Blocks and Transforaminal Epidural Injections (PDF)
Effective Date: 1/1/2022 |
Bariatric Surgery (PDF)
Effective Date: 1/1/2022 |
Implantable Intrathecal Pain Pump (PDF)
Effective Date: 1/1/2022 |
Short Inpatient Hospital Stay (PDF)
Effective Date: 1/1/2022 |
Biofeedback (PDF)
Effective Date: 1/1/2022 |
Implantable Wireless Pulmonary Artery Pressure Monitoring (PDF)
Effective Date: 1/1/2022 |
Skilled Nursing Facility Leveling (PDF)
Effective Date: 1/1/2022 |
Bone-anchored hearing aid (PDF)
Effective Date: 1/1/2022 |
Inhaled nitric oxide (PDF)
Effective Date: 1/1/2022 |
Skin Substitutes for Chronic Wounds (PDF)
Effective Date: 1/1/2022 |
Breast Procedures (Cosmetic, Reconstructive and Length of Stay) (PDF) Effective Date: 1/1/2022 |
Intensity-Modulated Radiotherapy (PDF)
Effective Date: 1/1/2022 |
Spinal Cord Stimulation (PDF)
Effective Date: 1/1/2022 |
Bronchial Thermoplasty (PDF)
Effective Date: 1/1/2022
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Intestinal and multivisceral transplant (PDF)
Effective Date: 1/1/2022
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Stereotactic Body Radiation Therapy (PDF)
Effective Date: 1/1/2022
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Burn Surgery (PDF)
Effective Date: 1/1/2022
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Intradiscal Steroid Injections for Pain Management (PDF)
Effective Date: 1/1/2022
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Tandem Transplant (PDF)
Effective Date: 1/1/2022
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Cardiac Biomarker Testing for Acute MI (PDF)
Effective Date: 1/1/2022 |
Laser Skin Treatment (PDF)
Effective Date: 1/1/2022
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Testing for Select Genitourinary Conditions (previously Diagnosis of Vaginitis) (PDF)
Effective Date: 1/1/2022
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Caudal or Interlaminar Epidural Steroid Injections (PDF)
Effective Date: 1/1/2022 |
Long Term Care Placement Criteria (PDF)
Effective Date: 1/1/2022
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Thymus Transplantation (PDF)
Effective Date: 1/1/2022
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Cell-free Fetal DNA Testing (PDF)
Effective Date: 1/1/2022 |
Low-Frequency Ultrasound Wound Therapy (PDF)
Effective Date: 1/1/2022
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Thyroid Testing in Pediatrics (PDF)
Effective Date: 1/1/2022
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Clinical Trials (PDF)
Effective Date: 1/1/2022 |
Lung Transplantation (PDF)
Effective Date: 1/1/2022
|
Total artificial heart (PDF)
Effective Date: 1/1/2022
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Cochlear Implant Replacements (PDF)
Effective Date: 1/1/2022 |
Lysis of Epidural Lesions (PDF)
Effective Date: 1/1/2022
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Total Parenteral Nutrition and Intradialytic Parenteral Nutrition (PDF)
Effective Date: 1/1/2022
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Cosmetic and Reconstructive Surgery (PDF)
Effective Date: 1/1/2022 |
Measure Serum 1,25 Vitamin D (PDF)
Effective Date: 1/1/2022
|
Transcatheter closure of patent foramen ovale (PDF)
Effective Date: 1/1/2022
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Dental Anesthesia (PDF)
Effective Date: 1/1/2022 |
Mechanical Stretching Devices for Joint Stiffness and Contracture (PDF)
Effective Date: 1/1/2022
|
Trigger Point Injections for Pain Management (PDF)
Effective Date: 1/1/2022
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Diaphragmatic/Phrenic Nerve Stimulation (PDF)
Effective Date: 1/1/2022 |
Multiple Sleep Latency Testing(PDF)
Effective Date: 1/1/2022
|
Urinary Incontinence Devices and Treatments (PDF)
Effective Date: 1/1/2022
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Disc Decompression Procedures (PDF)
Effective Date: 1/1/2022 |
Neonatal abstinence syndrome guidelines (PDF)
Effective Date: 1/1/2022
|
Vagus Nerve Stimulation (PDF)
Effective Date: 1/1/2022
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Discography (PDF)
Effective Date: 1/1/2022 |
Neonatal sepsis management (PDF)
Effective Date: 1/1/2022
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Ventricular Assist Devices (PDF)
Effective Date: 1/1/2022
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Digital EEG Analysis (PDF)
Effective Date: 1/1/2022 |
Nerve Blocks for Pain Management (PDF)
Effective Date: 1/1/2022
|
Video Electroencephalographic Monitoring (PDF)
Effective Date: 1/1/2022
|
Donor lymphocyte infusion (PDF)
Effective Date: 1/1/2022 |
Neuromuscular Electrical Stimulation (NMES) (PDF)
Effective Date: 1/1/2022
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Drugs of Abuse: Definitive Testing (previously Outpatient Testing for Drugs of Abuse) (PDF)
Effective Date: 1/1/2022 |
NICU Apnea Bradycardia Guidelines (PDF)
Effective Date: 1/1/2022
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Durable Medical Equipment (DME) (PDF)
Effective Date: 1/1/2022 |
NICU discharge guidelines (PDF)
Effective Date: 1/1/2022
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EEG in Evaluation of Headache (PDF)
Effective Date: 1/1/2022 |
Non-Invasive Home Ventilators (PDF)
Effective Date: 1/1/2022
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Electric Tumor Treating Fields (PDF)
Effective Date: 1/1/2022 |
Non-myeloablative allogeneic stem cell transplants (PDF)
Effective Date: 1/1/2022
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Electromyography and Nerve Conduction Studies (PDF)
Effective Date: 1/1/2022 |
Obstetrical Home Health Care Programs (PDF)
Effective Date: 1/1/2022
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Endometrial Ablation (PDF)
Effective Date: 1/1/2022 |
Optic nerve decompression surgery (PDF)
Effective Date: 1/1/2022
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Essure Removal (PDF)
Effective Date: 1/1/2022 |
Orthognathic Surgery (PDF)
Effective Date: 1/1/2022
|
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Evoked Potentials (PDF)
Effective Date: 1/1/2022 |
Osteogenic Stimulation (PDF)
Effective Date: 1/1/2022
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Experimental Technologies (PDF)
Effective Date: 1/1/2022 |
Outpatient Cardiac Rehabilitation (PDF)
Effective Date: 1/1/2022
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Evoked Potentials (PDF)
Effective Date: 1/1/2022 |
Oxygen Use and Concentrators (PDF)
Effective Date: 1/1/2022
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Facet Joint Interventions (PDF)
Effective Date: 1/1/2022 |
Pancreas transplant (PDF)
Effective Date: 1/1/2022
|
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Fecal incontinence treatments (PDF)
Effective Date: 1/1/2022 |
Panniculectomy (PDF)
Effective Date: 1/1/2022
|
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Ferriscan R2-MRI (PDF)
Effective Date: 1/1/2022 |
Pediatric heart transplant (PDF)
Effective Date: 1/1/2022
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Fertility preservation (PDF)
Effective Date: 1/1/2022 |
Pediatric Liver Transplant (PDF)
Effective Date: 1/1/2022
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Fetal surgery in utero for prenatally diagnosed malformations (PDF)
Effective Date: 1/1/2022 |
Pediatric Oral Function Therapy (PDF)
Effective Date: 1/1/2022
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Functional MRI (PDF)
Effective Date: 1/1/2022 |
Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention (PDF)
Effective Date: 1/1/2022
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Gastric Electrical Stimulation (PDF)
Effective Date: 1/1/2022 |
Physical, Occupational, and Speech Therapy Services (PDF)
Effective Date: 1/1/2022
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Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing (PDF)
Effective Date: 1/1/2022 |
Polymerase Chain Reaction Respiratory Viral Panel Testing (PDF)
Effective Date: 1/1/2022
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Gender Affirming Procedures (PDF)
Effective Date: 1/1/2022 |
Post-Acute Care (PDF)
Effective Date: 1/1/2022
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Genetic and Pharmacogenetic Testing (PDF)
Effective Date: 1/1/2022 |
Posterior tibial nerve stimulation for voiding dysfunction (PDF)
Effective Date: 1/1/2022
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PROM Testing (PDF)
Effective Date: 1/1/2022 |
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Proton and neutron beam therapies (PDF)
Effective Date: 1/1/2022 |
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