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Clinical Policy Bulletins
Periodic Reviews for 2008 Guidelines for Determining Coverage | Clinical Policy Bulletins | Medicare | Payment Policy
Changes to Review Schedule Please note that the attached sets forth the anticipated schedule for review of the specified Clinical Policy Bulletin (CPB) in the ordinary course. This schedule is subject to change based on various factors, including but not limited to intervening clinical developments and available resources. Aetna does not hereby commit to review any specific CPB by a specific date, and expressly reserves the right to change any CPB without notice. Aetna does not hereby assume any obligation to update information presented in this document, so information contained herein may be out of date at any given time. The CPB review dates below are the anticipated start dates of the CPB review process for each CPB listed. The "reviewed" date appearing on the CPB is the date the review is completed.
Anticipated CPB Review Date: January 10 001 - Transrectal Ultrasound 002 - Oxygen 003 - Apnea Monitors for Infants 004 - Obstructive Sleep Apnea 005 - Septoplasty and Rhinoplasty 007 - Erectile Dysfunction 008 - Color-Flow Doppler Echocardiography in Adults 009 - Orthopedic Casts, Braces and Splints 010 - Continuous Passive Motion (CPM) Machines 011 - Electrical Stimulation for Pain 013 - Cochlear Implants and Auditory Brainstem Implants 016 - Back Pain - Invasive Procedures 017 - Breast Reduction Surgery and Gynecomastia Surgery 019 - Holter Monitors 020 - Injectable Medications 021 - Cardiac Rehabilitation 022 - Calcitriol/Paricalcitol Injection (see also CPB 020 Injectable Medication Coverage) 023 - Corneal Remodeling 024 - Interleukin-2 (Aldesleukin, Proleukin, IL-2) 025 - Automated Ambulatory Blood Pressure Monitoring 027 - Implantable Vas Deferens Ligation Clip (Vasclip) 028 - Temporomandibular Disorders (TMD) and Temporomandibular Joint Syndrome (TMJ) Dysfunction, Diagnosis and Treatment 029 - Thermography 031 - Cosmetic Surgery 032 - Pulmonary Rehabilitation 034 - Aural Rehabilitation 035 - Influenza Vaccine 037 - Pneumococcal Vaccine 038 - Allergy Testing and Allergy Immunotherapy 039 - Weight Reduction Medications and Programs Anticipated CPB Review Date: January 24 046 - Routine Foot Care 047 - Prenatal Care Provided by Primary Care Physicians 048 - Hepatitis A Vaccine 049 - Nutritional Counseling 050 - Varicose Veins 055 - Hematopoietic Colony-Stimulating Factors (CSFs) 059 - Peak Flow Meters 061 - Nutritional Support 062 - Burn Treatment -- Burn Garments and Associated Physical and Occupational Therapies 065 - Nebulizers 067 - Chest Physiotherapy and Airway Clearance Devices 069 - Lymphedema Treatments 070 - Diabetes Programs and Supplies 071 - Positron Emission Tomography 073 - Cardiac Event Monitors 078 - Learning Disabilities, Dyslexia, & Vision 079 - Benign Prostatic Hypertrophy (BPH) Treatments 082 - Dental Services and Oral and Maxillofacial Surgery: Coverage Under Medical Plans 083 - Stereotactic Radiosurgery 084 - Ptosis Surgery 088 - Antepartum Fetal Surveillance 091 - Endometrial Ablation 093 - Open Air, Low Field Strength, and Standing MRI Units 094 - Magnetic Resonance Angiography (MRA) and Magnetic Resonance Venography (MRV) 095 - Orthognathic Surgery 097 - External Breast Prosthesis for Post-Mastectomy Patients 100 - Cryoablation 105 - Breast MRI 106 - Fetal Echocardiograms 107 - Chiropractic Services Anticipated CPB Review Date: February 14 111 - Indocyanine Green Angiography 112 - Surface Scanning and Macro Electromyography 113 - Botulinum Toxin 115 - Varicella and Herpes Zoster Vaccines 116 - Frenulectomy for Ankyloglossia 124 - General Anesthesia and I.V. Sedation for Oral and Maxillofacial Surgery and Dental Services 126 - Contact Lens and Eyeglasses 127 - Home Uterine Activity Monitoring 130 - Computerized Corneal Topography 131 - Hemophiliacs, Clotting Factor 132 - Biofeedback 134 - Bone Mass Measurements 135 - Acupuncture 136 - Skilled Home Private Duty Nursing Care 140 - Genetic Testing 142 - Breast Implants/Removal 145 - Alpha 1-Antitrypsin Inhibitor Therapy 147 - Reflex Sympathetic Dystrophy: Diagnostic Tests 151 - Hippotherapy for Cerebral Palsy and Other Motor Dysfunction 153 - Thalamotomy for Movement Disorders 155 - Ribavirin (Virazole) 157 - Obesity Surgery 158 - Neuropsychological Testing (NPT) 160 - Lung Volume Reduction Surgery 161 - Infusion Pumps 163 - Transmyocardial Laser Revascularization (TMLR) 165 - Cardiac Catheter Ablation Procedures 166 - Fetal Fibronectin and Salivary Estriol Testing for Preterm Labor Anticipated CPB Review Date: February 28 168 - Tumor Scintigraphy 169 - Outpatient Medical Self Care Programs 170 - Growth Hormone (GH), Growth Hormone Releasing Hormone (GHRH), and Growth Hormone Antagonists 171 - Extremity MRI 172 - Hyperbaric Oxygen Therapy (HBOT) 173 - Prothrombin Time Home / International Normalization Ratio (INR) Testing Systems 174 - Pool Therapy, Aquatic Therapy or Hydrotherapy 175 - High-Frequency Pulsed Electromagnetic Stimulation 177 - Urea Breath Testing for H. Pylori Infection 179 - Viscosupplementation for Osteoarthritis 180 - Vertebral Axial Decompression Therapy 181 - Evoked Potential Studies 182 - Ventricular Remodeling Operation (Batista Procedure) 184 - Prostaglandin Infusion Therapy for Pulmonary Hypertension 185 - Breast Reconstructive Surgery 188 - Total Body Photography and Dermoscopy/Dermatoscopy 189 - Genetic Counseling 190 - Stem Cells for Bone Marrow Transplant 191 - Vagus Nerve Stimulation 194 - Dorsal Column Stimulation 195 - Erythropoietin and Darbepoetin Therapy 198 - Work Hardening Programs 199 - Ultrasound for Pregnancy 200 - Coumadin (Warfarin) to Heparin Conversion Before and After Elective Surgery 201 - Skilled Home Health Care Nursing Services 202 - Magnetic Resonance Spectroscopy (MRS) 204 - Spinal Manipulation Under Anesthesia 205 - Phototherapy and Photochemotherapy (PUVA) for Skin Conditions 206 - Intravenous Immunoglobulins (IVIG) 207 - Prolotherapy Anticipated CPB Review Date: March 13 208 - Deep Brain Stimulation 210 - Phonophoresis 211 - Abdominoplasty, Suction Lipectomy, and Ventral Hernia Repair 212 - Metrecom Skeletal Analysis System 213 - Gastroesophageal Reflux Disease (GERD): Treatment Devices 214 - Cognitive Rehabilitation 215 - Lyme Disease and other Tick-Borne Diseases 218 - Home Health Aides 220 - Ilizarov Method for Distraction Osteosynthesis 221 - Quantitative EEG (Brain Mapping) 223 - Urinary Incontinence Treatments 225 - Maze Procedure 226 - Hospitalization for the Initiation of Ketogenic Diet for the Treatment of Intractable Seizures 227 - BRCA Testing, Prophylactic Mastectomy, Tamoxifen, and Prophylactic Oophorectomy for Persons at Risk for Breast and Ovarian Cancer 228 - CT Angiography and Calcium Scoring for Evaluating Coronary Artery Disease 229 - Iontophoresis 231 - Grenz Ray Therapy for Skin Disorders 232 - Back Pain - Non Invasive Treatments 234 - Chelation Therapy 235 - Plantar Fasciitis Treatments 236 - MRI and CT of the Spine 237 - Chronic Pain Programs 238 - Chronic Vertigo 240 - Antineoplaston Therapy and Sodium Phenylbutyrate 241 - Extracorporeal Photochemotherapy (Photopheresis) 243 - Speech Therapy 244 - Wound Care 245 - Tumor Chemosensitivity and Chemoresistance Assays 247 - Autologous Chondrocyte Implantation 248 - Fiberoptic Endoscopic Evaluation of Swallowing (FEES) / Fiberoptic Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST) Anticipated CPB Review Date: March 27 249 - Inflammatory Bowel Disease: Serologic Markers and Pharmacogenomic and Metabolic Assessment of Thiopurine Therapy 250 - Occupational Therapy Services 251 - Dermabrasion, Chemical Peels, and Acne Surgery 253 - Injections for Vocal Cord Paralysis 255 - Inpatient Admission Prior to Surgery (Preop Days) 256 - Sensory and Auditory Integration Therapy 259 - Transjugular Intrahepatic Portosystemic Shunt (TIPSS) 262 - External Counterpulsation (ECP) 263 - Gait Analysis and Electrodynogram 264 - Multiple Sclerosis 265 - Surgical Treatments to Control Drooling (Sialorrhea) 266 - Cholecystokinin Cholescintigraphy 267 - Ornish Cardiac Treatment Program 268 - Liver Neoplasms - Treatment Approaches 269 - Breast Biopsy Procedures 270 - Proton Beam and Neutron Beam Radiotherapy 271 - Wheelchairs 272 - Pectus Excavatum and Poland's Syndrome Surgical Correction 274 - Cryosurgical and Radiofrequency Ablation of Hepatic Lesions 276 - Angioplasty and Stenting of Extra-Cranial and Intra-Cranial Arteries 278 - Hyperthermia in Cancer Therapy 279 - Magnetic Source Imaging/Magnetoencephalography 282 - Down Syndrome Screening By Ultrasonographic Assessment Of Fetal Nuchal Thickening (NT) / Nuchal Translucency Testing 284 - Melodic Intonation Therapy for Persistent Aphasia 285 - Plasmapheresis/Plasma Exchange/Therapeutic Apheresis 287 - Total Hip Implants 288 - Stereotactic Cingulotomy 289 - Grid Monitoring: Presurgical Evaluation for Patients with Intractable Seizures 290 - Scalp Cooling (Hypothermia) To Prevent Hair Loss During Chemotherapy 291 - Hemodialysis for the Treatment of Schizophrenia Anticipated CPB Review Date: April 10 292 - Transcatheter Closure of Septal Defects 293 - Corneal Graft with Amniotic Membrane Transplantation 294 - Pedobarography 295 - Peripheral Atherectomy 297 - Cryoanalgesia and Therapeutic Cold 298 - Non-invasive Negative Pressure Ventilation: Body Ventilators and Poncho Wrap 299 - Tilt Table Testing 300 - Hair Analysis 302 - Electrical Stimulation (Salitron System) for Xerostomia 304 - Fibroid Treatment 305 - Videostroboscopy 306 - Dexamethasone Suppression Test in Psychiatry 307 - Parkinson's Disease, Surgical Treatment 310 - Thoracoscopic Sympathectomy 313 - Herceptin (Trastuzumab) 314 - Rituximab (Rituxan) 315 - Enbrel™ (Etanercept) 316 - HIV Drug Susceptibility and Resistance Tests 317 - Ultra Rapid Detoxification (UROD) 318 - Synagis (Palivizumab) for Prevention of Respiratory Syncytial Virus (RSV) Infections 319 - RET Proto-Oncogene Testing 321 - Visual Perceptual Training 322 - Electroencephalographic (EEG) Video Monitoring 323 - Preconceptional Sex Selection Techniques 325 - Physical Therapy Services 327 - Infertility 329 - Home Births 330 - Multiple Sleep Latency Test (MSLT) 332 - Neonatal Hyperbilirubinemia 334 - Negative Pressure Wound Therapy Anticipated CPB Review Date: April 24 336 - Acoustic Pharyngometers and SNAP™ Testing System 337 - BreastAlert™ Differential Temperature Sensor 339 - Pulse Oximeter for Home Use 340 - Antibody Screening Tests for Neurologic Diseases 341 - Remicade (infliximab) 342 - Intestinal Rehabilitation Programs 343 - Bone Growth Stimulators 344 - Optic Nerve and Retinal Imaging Methods 345 - Implantable Hormone Pellets 346 - Low-Molecular-Weight Heparins 347 - Transcervical Balloon Tuboplasty 348 - Recurrent Pregnancy Loss 349 - Alzheimer's Disease: Diagnosis 351 - Flow Cytometry, DNA Ploidy, and S-phase Fraction 352 - Tumor Markers 353 - Transcranial Doppler Ultrasonography 354 - YAG Laser Capsulotomy 355 - Extracorporeal Immunoadsorption (Prosorba column) 356 - Meningococcal Vaccine 357 - Quantitative Sensory Testing (QST) / Current Perception Threshold (CPT) Testing 358 - Prenatal Diagnosis of Genetic Diseases 361 - Metastron® (Strontium-89) Injection 362 - Neurosurgical Management of Spasticity 363 - Cold Laser Therapy 364 - Allograft Transplants of the Lower Extremity 365 - Pancreaticoduodenectomy (Whipple Resection) for Zollinger-Ellison Syndrome 366 - Gold Weight Eyelid Implants 367 - Home Cholesterol Monitors 368 - Obstetrical Hypertension Programs 369 - Chronic Fatigue Syndrome, Diagnosis Anticipated CPB Review Date: May 8 370 - Phototherapy for Seasonal Affective Disorder 371 - Brachytherapy 372 - Warm-Up® Therapy/Noncontact Normothermic Wound Therapy 373 - Crit-Line In-Line Monitor 374 - Trigeminal Neuralgia - Surgical Treatment 375 - Photodynamic Therapy for Cancer 376 - Single Photon Emission Computed Tomography (SPECT) 377 - Dendritic Cell Immunotherapy 378 - NeuroControl Freehand System 379 - Cranial Remodeling Bands and Helmets 380 - Lung Cancer Screening 381 - Cardiac Disease Risk Tests 382 - Intravascular Ultrasound 383 - Mohs Micrographic Surgery 384 - Magnetic Resonance Cholangiopancreatography 386 - Breast Transillumination and Electrical Impedance Scanning (EIS) 387 - Magnetic Resonance Neurography 388 - Complementary and Alternative Medicine 389 - Silicone for Hypertrophic Scars and Keloids 390 - Smell and Taste Disorders - Diagnostic Procedures and Services 392 - Metabolic and Environmental Profiling for Kidney Stone Risk 393 - Vitrectomy Face Support 394 - Surgery for Intractable Epilepsy 395 - Ethanol Injection Sclerotherapy for Thyroglossal Duct Cyst 396 - Electrogastrography / Colonic Motility Studies 397 - Knee Ligament Arthrometer Testing 398 - Idiopathic Scoliosis Treatments 399 - Myoelectric Prosthesis 400 - Ernest Eagle's Syndrome (Stylomandibular Ligament Pain): Treatment with Radiofrequency Thermoneurolysis 401 - Selective Peripheral Denervation (Bertrand Procedure) for Spasmodic Torticollis Anticipated CPB Review Date: May 22 402 - Polio Vaccine 403 - Bone-anchored Hearing Aid 404 - Interferons 405 - Mechanical Stretching Devices for Contracture and Joint Stiffness 406 - Tinnitus Treatments 407 - Ross Pulmonary Autograft for Aortic Valve Replacement 409 - Macular / Foveal Translocation 410 - Hepatitis B Vaccine 411 - Bone Graft Substitutes and Adjuncts 412 - Therabite® Jaw Motion Rehabilitation System 413 - Percutaneous Embolization of Varicocele 414 - AcuTect/Scintigraphic Imaging for Detection/Localization of Lower Limb Deep Vein Thrombosis 415 - Optic Nerve Decompression Surgery 416 - Sural Nerve Graft During Radical Retropubic Prostatectomy 417 - Amnioinfusion 418 - Myringotomy and Tympanostomy Tube 419 - Graves' Ophthalmopathy: Surgical Procedures 420 - Balloon Dacryocystoplasty/Dacryoplasty for Nasolacrimal Duct Obstruction 421 - Breast Pumps 422 - Vitiligo 423 - Alopecia Areata 425 - Ambulatory Electroencephalography for the Diagnosis and Management of Epilepsy 426 - Attention Deficit/Hyperactivity Disorder 427 - Carbon Dioxide Laser for Actinic Lesions of the Skin 428 - Carbogen Inhalation Therapy for the Treatment of Sudden Hearing Loss 429 - Bathroom and Toilet Equipment and Supplies 430 - Pressure Reducing Support Surfaces 431 - Bedwetting Alarm for Nocturnal Enuresis 432 - Computerized Motion Diagnostic Imaging 433 - Chlamydia Trachomatis - Screening and Diagnosis Anticipated CPB Review Date: June 12 434 - Therapeutic Chairs 435 - Viscocanalostomy 437 - Speech Generating Devices 438 - Obsolete or Unreliable Pathology and Laboratory Diagnostic Tests 441 - Ovarian Vein Embolization for Pelvic Congestion Syndrome 442 - Enzyme-replacement Therapy for Lipidoses and Mucopolysaccharidoses 443 - Cervical Cancer Screening 444 - Early Intervention Programs 445 - Electroconvulsive Therapy 446 - Endoscopic Ultrasonography Procedures 447 - Complex Regional Pain Syndrome (CRPS) / Reflex Sympathetic Dystrophy (RSD) Treatments 449 - Fetal Surgery In Utero 450 - Fluidized Therapy (Fluidotherapy) 451 - Foot Orthotics 452 - Noninvasive Positive Pressure Ventilation 453 - Cervical Traction Devices (Hometrac and Pronex) 456 - Pillows and Cushions 457 - Punctal Plugs and Punctoplasty for Dry Eyes 458 - Peripheral Vascular Rehabilitation Programs 459 - Seat Lifts and Patient Lifts 462 - Dihydroergotamine (DHE) Therapy for Intractable Migraine or Cluster Headache 464 - Serum Marker Screening for Down Syndrome 465 - Mifepristone (RU 486) 466 - Clinical Trials, Coverage of Routine Patient Care Costs 467 - Vestibular Autorotation Test (VAT) 468 - Terbutaline Pump for Preterm Labor 469 - Transcranial Magnetic Stimulation and Cranial Electrical Stimulation 471 - Tuberculosis Testing 472 - Thoracic Electrical Bioimpedance for Cardiac Output Monitoring 473 - Vaccines for Trav el Anticipated CPB Review Date: June 26 474 - Total Body Plethysmography 475 - Coblation™ Non-thermal Volumetric Tissue Reduction 476 - Influenza Rapid Diagnostic Tests 477 - Balloon Valvuloplasty 479 - Respiratory Devices: Incentive Spirometers and Intermittent Positive Pressure Breathing Machines 480 - Tourette Syndrome 481 - Tables and Boards 482 - Compression Garments for the Legs 483 - Anthrax Vaccine 484 - Aqueous Drainage/Shunt Implant for Refractory Primary Open-Angle Glaucoma 485 - Autonomic Testing / Sudomotor Tests 489 - Vision Therapy 490 - Transpupillary Thermal Therapy 491 - Coronary Artery Brachytherapy 492 - Radiofrequency Tumor Ablation 493 - Kidney Transplantation 494 - High Dose Chemotherapy and Bone Marrow or Peripheral Stem Cell Transplant for Non-Hodgkin's Lymphoma 495 - High Dose Chemotherapy Bone Marrow or Peripheral Stem Cell Transplant for Hodgkin's Disease 496 - High Dose Chemotherapy Bone Marrow or Peripheral Stem Cell Transplant for Neuroblastoma 497 - High Dose Chemotherapy Bone Marrow or Peripheral Stem Cell Transplant for Multiple Myeloma 500 - Intermittent Pneumatic Compression Devices for the Legs 501 - Gonadotropin-Releasing Hormone Analogs (Lupron/Zoladex) and Antagonists (Plenaxis) 502 - Nerve Conduction Velocity Studies 503 - Suction Pumps 504 - Hyperhidrosis (Hyperhydrosis) 505 - Ambulatory Assist Devices: Walkers, Canes, and Crutches 507 - Breast Cancer: High-Dose Chemotherapy with Autologous Stem Cell Support 508 - Cataract Removal Surgery 509 - Contact Dissolution for the Treatment of Gallstones Anticipated CPB Review Date: July 10 510 - Progestins 511 - Eating Disorders (Anorexia and Bulimia): Inpatient Services 512 - Premenstrual Syndrome/Premenstrual Dysphoric Disorder 514 - Surgical Treatments for Meniere's Disease 515 - Thyrogen (Thyrotropin Alfa) 516 - Colorectal Cancer Screening 517 - Breast Ductal Lavage and Fiberoptic Ductoscopy 518 - Nitric Oxide, Inhalational (INO) 520 - Magnetic Resonance Imaging of the Cardiovascular System - Cardiac MRI 521 - Prostate Cancer Screening 522 - Pulsed Irrigation Evacuation (PIE) 523 - Car-Ride Simulators for Infantile Colic 524 - Zometa (Zoledronic Acid) 525 - Screening for Lipid Disorders 526 - Surgical Dressings (Wound Care Supplies) 527 - Intragastric Hypothermia 528 - Androgens and Anabolic Steroids 529 - Transabdominal Cerclage 530 - Transvaginal Ultrasonography for Ovarian and Endometrial Cancer Screening 531 - Venous Stents, Balloon-Expandable 532 - Scrotal Ultrasonography 533 - Urological Supplies 534 - Vesicoureteral Reflux Treatment by Endoscopic Injection of Bulking Agents 535 - Virtual Colonoscopy 536 - Vitamin B-12 Deficiency 538 - Endothelial Cell Photography 539 - Fundus Photography 540 - Heating Devices 541 - Home Dialysis 542 - HIV Testing Anticipated CPB Review Date: July 24 543 - Hospital Beds and Accessories 544 - Immune Globulins for Postexposure Prophylaxis 545 - Electrothermal Arthroscopic Surgery 546 - Extracorporeal Membrane Oxygenation (ECMO) 547 - Rosacea 548 - Cardiovascular Monitoring Equipment for Home Use: Pulse, Blood Pressure, Telemonitors, and Pacemaker Monitors 549 - Distraction Osteogenesis for Craniofacial Skeletal Deformities 551 - Radiation Treatment of Keloids 552 - Laser Neurolysis 553 - Lead Testing 556 - Medicinal Leech Therapy 557 - Melanoma Vaccine 558 - Percutaneous Transluminal Septal Myocardial Ablation (PTSMA) 559 - Pulsed Dye Laser Treatment 560 - Voice Prosthesis for Voice Rehabilitation Following Total Laryngectomy 561 - Laboratory Testing for Celiac Disease 562 - Biochemical Markers of Bone Remodeling for Osteoporosis 563 - Diabetic Retinopathy Telescreening Systems 564 - Electrocochleogram and Perilymphatic Pressure Measurement 565 - Ankle Orthoses, Ankle-Foot Orthoses (AFOs), and Knee-Ankle-Foot Orthoses (KAFOs) 566 - Strabismus Repair in Adults 567 - Actinic Keratoses Treatment 568 - AngioJet Rheolytic Thrombectomy System 569 - Lumbar Traction Devices 570 - Chemotherapy Inpatient 571 - Dehydration Testing for Endolymphatic Hydrops (Meniere's Disease) 572 - Home/Ambulatory Spirometry 574 - Female Erectile Devices for the Treatment of Female Sexual Dysfunction (FSD) 575 - Intravenous Iron Therapy 576 - Laminoplasty Anticipated CPB Review Date: August 14 577 - Psoriasis Laser Treatment 578 - Lower Limb Prostheses 579 - T-Wave Alternans 580 - Low Vision Programs 581 - Lung Imaging Fluorescence Endoscopy (LIFE) 582 - The Titanium Rib 583 - Eye Movement Desensitization and Reprocessing (EMDR) Therapy 584 - Mammography 585 - Cardioverter-Defibrillators 586 - Heart Transplantation 587 - Pancreas Kidney Transplantation 588 - Capsule Endoscopy 590 - Intensity Modulated Radiation Therapy 591 - Intervertebral Disc Prostheses 592 - Turbinate Somnoplasty- Radiofrequency Ablation of Hypertrophied Nasal Turbinates 593 - Aerosolized Anti-infective Treatment for Sinusitis 594 - Visudyne (Verteporfin) Photodynamic Therapy 595 - Kineret (Anakinra) 596 - Liver Transplantation 597 - Heart-Lung Transplant 598 - Lung Transplantation 599 - Autologous Skeletal Myoblast/Mononuclear Bone Marrow Cell Transplantation for Cardiac Diseases 601 - Pancreas Transplantation Alone / Islet Cell Transplantation 602 - Nucleoplasty 603 - Total-Body CT Screening 604 - Infrared Therapy 605 - Intestinal Transplantation 606 - Stem Cell Transplant for Autoimmune Diseases 607 - Intralesional and Intraarticular Anesthetic Pumps 608 - Salivary Hormone Tests Anticipated CPB Review Date: August 28 609 - Laser Photocoagulation of Drusen 610 - Biventricular Pacing (Cardiac Resynchronization Therapy) / Combination Resynchronization-Defibrillation Devices for Congestive Heart Failure 611 - Fecal Incontinence Treatments 612 - Implantable Hearing Aids- Vibrant Soundbridge 613 - Stereolithography 614 - Fetal Striatal Transplantation for Huntington's Disease 615 - Sex Reassignment Surgery 616 - Antroduodenal Manometry 617 - High Dose Chemotherapy Bone Marrow or Peripheral Stem Cell Transplant for Testicular Cancer 618 - Brain Natriuretic Peptide in Congestive Heart Failure 619 - Eye Prosthesis 620 - Facial Prostheses, External 621 - Drug-Eluting Stents 622 - Ocular Blood Flow Tonometer 623 - Safety Items 625 - Dysphagia Therapy 626 - High Dose Chemotherapy Allogeneic Bone Marrow or Peripheral Stem Cell Transplant for Thalassemia Major and Sickle Cell Anemia 627 - High Dose Chemotherapy Allogeneic Bone Marrow or Peripheral Stem Cell Transplant for Aplastic Anemia 628 - Spinal Ultrasound 629 - Bunionectomy 630 - Vacuum Assisted Socket System (VASS) 633 - Benign Skin Lesion Removal 634 - Non-myeloablative Bone Marrow-Peripheral Stem Cell Transplantation (Mini-Allograft-Reduced Intensity Conditioning Transplant) 635 - High Dose Chemotherapy and Bone Marrow or Peripheral Stem Cell Transplant for Ovarian Cancer 636 - Hammer Toe Repair 637 - Osteochondral Autografts (Mosaicplasty, OATS) 638 - Donor Lymphocyte Infusion 639 - Autotransfusers 640 - Bone Marrow or Peripheral Stem Cell Transplant for Acute Lymphocytic Leukemia 641 - Adoptive Immunotherapy Anticipated CPB Review Date: September 11 642 - Neuralgia Inducing Cavitational Osteonecrosis (NICO) and Ultrasonograph Bone Densitometer to Detect NICO 643 - DNA Hybridization Assays for Diagnosis of Vaginitis 644 - Smallpox Vaccine 645 - Total Ankle Arthroplasty 646 - Voice Therapy 647 - Histamine Desensitization Therapy for Intractable Headaches 648 - Pervasive Developmental Disorders 649 - Extracorporeal Shock Wave Therapy for Musculoskeletal Indications 650 - Polymerase Chain Reaction Testing: Selected Indications 651 - Endovascular Repair of Aortic Aneurysms 652 - Therapeutic Phlebotomy 653 - Diphtheria, Tetanus, and Pertussis Vaccines 654 - Ventricular Assist Devices 655 - Adalimumab (Humira) 656 - Phototherapy for Acne 657 - Hysteroscopic Tubal Sterilization: Essure Micro-Insert 658 - Psoriasis: Biological Therapies 659 - Radioimmunotherapy for Non-Hodgkin's Lymphoma: Ibritumomab Tiuxetan (Zevalin) and Tositumomab (Bexxar) 660 - Unicompartmental Knee Arthroplasty 661 - Hip Resurfacing 662 - Antiprothrombin Antibody Testing 663 - Computed Tomography Perfusion Imaging 664 - Signal-Averaged Electrocardiography (SAECG) 665 - Constraint-Induced Movement Therapy 666 - Teriparatide (Forteo) 667 - Esophageal pH Monitoring 668 - Central Auditory Processing Disorder (CAPD) 669 - Maxwell-Brancheau Arthroereisis (MBA) Implant 670 - Xolair (Omalizumab) 671 - Enfuvirtide (Fuzeon) Anticipated CPB Review Date: September 25 672 - Pamidronate (Aredia) 673 - Arthroscopic Lavage and Debridement for Osteoarthritis of the Knee 674 - High Dose Chemotherapy Bone Marrow or Peripheral Stem Cell Transplantation for Chronic Myelogenous Leukemia 675 - Bortezomib (Velcade) 676 - Electrical Stimulation for Nausea, Vomiting and Motion Sickness (ReliefBand) 677 - Functional Electrical Stimulation and Neuromuscular Electrical Stimulation 678 - Gastric Pacing / Gastric Electrical Stimulation 679 - Electrical Stimulation for Levator Syndrome 680 - Electrical Stimulation for Chronic Ulcers 681 - Pachymetry of Cornea 682 - Microwave Thermotherapy for Breast Cancer 683 - Oxaliplatin (Eloxatin) 684 - Cetuximab (Erbitux) 685 - Bevacizumab (Avastin) 686 - Oral Brush Biopsy 687 - Pemetrexed (Alimta) 688 - Intra-oral Appliances for Migraines 689 - Ocular Photoscreening 690 - Serum Markers for Hepatic Fibrosis 691 - Exhaled Nitric Oxide 692 - Acoustic Heart Sound Recording and Computer Analysis 693 - Octreotide (Sandostatin) 694 - Paranasal Sinus Ultrasound for the Evaluation of Sinusitis 695 - Broth Culture Testing for Interstitial Cystitis 696 - Suit Therapy for Cerebral Palsy 697 - Intra-operative Monitoring of Electromyography 698 - Prostate Saturation Biopsy 699 - Dry Hydrotherapy (Hydromassage, Aquamassage, Water Massage) 700 - Rhinomanometry and Acoustic Rhinometry 701 - Macugen (Pegaptanib) Anticipated CPB Review Date: October 23 702 - Abdominal Aortic Aneurysm Screening 703 - Thermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow 704 - Indirect Measurement of Left Ventricular Filling Pressure (LVFP): The VeriCor System 705 - Body Surface Potential Mapping 706 - Anecortave Acetate (Retaane) 707 - Cervicogenic Headache and Occipital Neuralgia: Invasive Procedures 708 - Metatarsal Phalangeal Joint Replacement of the Hallux 709 - Nesiritide (Natrecor) 710 - Actigraphy Testing 711 - Increlex (Mecasermin) 712 - Ziconotide (Prialt) 713 - Artificial Retina 714 - Re-breathing of Inert Gas for Measurement of Cardiac Output 715 - Pharmacogenetic Testing 716 - Extracorporeal Shock Wave Lithotripsy for Sialolithiasis (Salivary Stones) 717 - Analysis of Volatile Organic Compounds to Detect Bacteriuria 718 - Defecography / Evacuation Proctography 719 - Retisert (Fluocinolone Acetonide) Intra-vitreal Implant 720 - Abatacept (Orencia) 721 - Intraoperative Radiation Therapy (IORT) 722 - Selective Nerve Root Blocks 723 - Rotavirus Vaccine 724 - Serotonin 3 (5-HT3) Receptor Antagonist Antiemetic Injection Therapy 725 - Post-herpetic Neuralgia 726 - Cervical Cancer Vaccine: Gardasil 727 - Ibandronate Sodium (Boniva) Injection 728 - Barrett's Esophagus Surgery 729 - Surgical Decompression for Diabetic Neuropathy 730 - Home Behavioral Healthcare Services 731 - Convestion-Enhanced Intraparenchymal Delivery of Drugs to the Brain Anticipated CPB Review Date: November 13 732 - Guilain-Barre Syndrome: Treatments 733 - Discography 734 - External Ocular Photography 735 - Pulsed Radiofrequency 736 - Femoro-Acetabular Surgery for Hip Impingement Syndrome 737 - Double Balloon Enteroscopy 738 - Esophagogastroduodenoscopy/Upper Gastrointestinal Endoscopy 739 - Functional Magnetic Resonance Imaging 740 - Anesthesia Services for Gastrointestinal Endoscopy 741 - Peripheral Ultrafiltration for Acute Decompensated Heart Failure 742 - Intermittent Intravenous Insulin Therapy 743 - Spinal Surgery: Laminectomy and Fusion |
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