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 (PDF)
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 |
Sacroiliac joint fusion (PDF)
Effective Date: 1/1/2022 |
Ambulatory EEG (PDF)
Effective Date: 1/1/2022 |
Homocysteine Testing (PDF)
Effective Date: 1/1/2022 |
Sacroiliac Joint Interventions for Pain Management (PDF)
Effective Date: 1/1/2022 |
Ambulatory Surgery Center Optimization (PDF)
Effective Date: 1/1/2022 |
Hospice Services (PDF)
Effective Date: 1/1/2022 |
Scanning computerized Ophthalmic Diagnostic Imaging (SCODI) (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 |
Bronchial Thermoplasty (PDF)
Effective Date: 1/1/2022 |
Intensity-Modulated Radiotherapy (PDF)
Effective Date: 1/1/2022 |
Spinal Cord Stimulation (PDF)
Effective Date: 1/1/2022 |
Burn Surgery (PDF)
Effective Date: 1/1/2022 |
Intestinal and Multivisceral Transplant (PDF)
Effective Date: 1/1/2022 |
Stereotactic Body Radiation Therapy (PDF)
Effective Date: 1/1/2022 |
Cardiac Biomarker Testing for Acute MI (PDF)
Effective Date: 1/1/2022 |
Intradiscal Steroid Injections for Pain Management (PDF)
Effective Date: 1/1/2022 |
Tandem Transplant (PDF)
Effective Date: 1/1/2022 |
Caudal or Interlaminar Epidural Steroid Injections (PDF)
Effective Date: 1/1/2022 |
Laser Skin Treatment (PDF)
Effective Date: 1/1/2022 |
Testing for Select Genitourinary Conditions (previously Diagnosis of Vaginitis) (PDF)
Effective Date: 1/1/2022 |
Cell-free Fetal DNA Testing (PDF)
Effective Date: 1/1/2022 |
Long Term Care Placement Criteria (PDF)
Effective Date: 1/1/2022
|
Thymus Transplantation (PDF)
Effective Date: 1/1/2022 |
Clinical Trials (PDF)
Effective Date: 1/1/2022 |
Low-Frequency Ultrasound Wound Therapy (PDF)
Effective Date: 1/1/2022 |
Thyroid Testing in Pediatrics (PDF)
Effective Date: 1/1/2022 |
Cochlear Implant Replacements (PDF)
Effective Date: 1/1/2022 |
Lung Transplantation (PDF)
Effective Date: 1/1/2022
|
Total artificial heart (PDF)
Effective Date: 1/1/2022 |
Cosmetic and Reconstructive Surgery (PDF)
Effective Date: 1/1/2022 |
Lysis of Epidural Lesions (PDF)
Effective Date: 1/1/2022
|
Total Parenteral Nutrition and Intradialytic Parenteral Nutrition (PDF)
Effective Date: 1/1/2022 |
Dental Anesthesia (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 |
Diaphragmatic/Phrenic Nerve Stimulation (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 |
Digital EEG Analysis (PDF)
Effective Date: 1/1/2022
|
Multiple Sleep Latency Testing (PDF)
Effective Date: 1/1/2022
|
Ultrasound in Pregnancy (PDF)
Effective Date: 1/1/2022 |
Disc Decompression Procedures (PDF)
Effective Date: 1/1/2022 |
Neonatal abstinence syndrome guidelines (PDF)
Effective Date: 1/1/2022
|
Urinary Incontinence Devices and Treatments (PDF)
Effective Date: 1/1/2022 |
Discography (PDF)
Effective Date: 1/1/2022 |
Neonatal sepsis management (PDF)
Effective Date: 1/1/2022
|
Urodynamic Testing (PDF)
Effective Date: 1/1/2022 |
Donor lymphocyte infusion (PDF)
Effective Date: 1/1/2022 |
Nerve Blocks for Pain Management (PDF)
Effective Date: 1/1/2022
|
Vagus Nerve Stimulation (PDF)
Effective Date: 1/1/2022 |
Drugs of Abuse: Definitive Testing (previously Outpatient Testing for Drugs of Abuse) (PDF)
Effective Date: 1/1/2022 |
Neuromuscular Electrical Stimulation (NMES) (PDF)
Effective Date: 1/1/2022
|
Ventricular Assist Device (PDF)
Effective Date: 1/1/2022 |
Durable Medical Equipment (DME) (PDF)
Effective Date: 1/1/2022 |
NICU Apnea Bradycardia Guidelines (PDF)
Effective Date: 1/1/2022
|
Video Electroencephalographic Monitoring (PDF)
Effective Date: 1/1/2022 |
EEG in Evaluation of Headache (PDF)
Effective Date: 1/1/2022 |
NICU discharge guidelines (PDF)
Effective Date: 1/1/2022
|
Vitamin D Testing in Children (PDF)
Effective Date: 1/1/2022 |
Electric Tumor Treating Fields (PDF)
Effective Date: 1/1/2022 |
Non-invasive Home Ventilators (PDF)
Effective Date: 1/1/2022 |
Wheelchair Seating (PDF)
Effective Date: 1/1/2022 |
Electromyography and Nerve Conduction Studies (PDF)
Effective Date: 1/1/2022 |
Non-myeloablative Allogeneic Stem Cell Transplants (PDF)
Effective Date: 1/1/2022 |
Wireless Motility Capsule (PDF)
Effective Date: 1/1/2022 |
Endometrial Ablation (PDF)
Effective Date: 1/1/2022 |
Obstetrical Home Health Care Programs (PDF)
Effective Date: 1/1/2022 |
|
Essure Removal (PDF)
Effective Date: 1/1/2022 |
Optic Nerve Decompression Surgery (PDF)
Effective Date: 1/1/2022 |
|
Evoked Potentials (PDF)
Effective Date: 1/1/2022 |
Orthognathic Surgery (PDF)
Effective Date: 1/1/2022 |
|
Experimental Technologies (PDF)
Effective Date: 1/1/2022 |
Osteogenic Stimulation (PDF)
Effective Date: 1/1/2022 |
|
External Ocular Photography (PDF)
Effective Date: 1/1/2022 |
Outpatient Cardiac Rehabilitation (PDF)
Effective Date: 1/1/2022 |
|
Facet Joint Interventions (PDF)
Effective Date: 1/1/2022 |
Oxygen Use and Concentrators (PDF)
Effective Date: 1/1/2022 |
|
Fecal incontinence treatments (PDF)
Effective Date: 1/1/2022 |
Pancreas Transplant (PDF)
Effective Date: 1/1/2022 |
|
Ferriscan R2-MRI (PDF)
Effective Date: 1/1/2022 |
Panniculectomy (PDF)
Effective Date: 1/1/2022 |
|
Fertility preservation (PDF)
Effective Date: 1/1/2022 |
Pediatric Heart Transplant (PDF)
Effective Date: 1/1/2022 |
|
Fetal surgery in utero for prenatally diagnosed malformations (PDF)
Effective Date: 1/1/2022 |
Pediatric Liver Transplant (PDF)
Effective Date: 1/1/2022 |
|
Fluorescein Angiography (PDF)
Effective Date: 1/1/2022 |
Pediatric Oral Function Therapy (PDF)
Effective Date: 1/1/2022 |
|
Fundus Photography (PDF)
Effective Date: 1/1/2022 |
Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention (PDF)
Effective Date: 1/1/2022 |
|
Functional MRI (PDF)
Effective Date: 1/1/2022 |
Physical, Occupational, and Speech Therapy Services (PDF)
Effective Date: 1/1/2022 |
|
Gastric Electrical Stimulation (PDF)
Effective Date: 1/1/2022 |
Polymerase Chain Reaction Respiratory Viral Panel Testing (PDF)
Effective Date: 1/1/2022 |
|
Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing (PDF)
Effective Date: 1/1/2022 |
Posterior tibial nerve stimulation for voiding dysfunction (PDF)
Effective Date: 1/1/2022
|
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Gender Affirming Procedures (PDF)
Effective Date: 1/1/2022 |
PROM Testing (PDF)
Effective Date: 1/1/2022
|
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Genetic and Pharmacogenetic Testing (PDF)
Effective Date: 1/1/2022 |
Proton and neutron beam therapies (PDF)
Effective Date: 1/1/2022
|
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Gonioscopy (PDF)
Effective Date: 1/1/2022 |
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