Clinical policy bulletins
What's New in the Clinical Policy Bulletins
Additions, Revisions, Updates, and Deletions Sorted by Date
New:
Revised:
- November 20, 2009 - 0650 - Polymerase Chain Reaction Testing: Selected Indications
- November 20, 2009 - 0652 - Therapeutic Phlebotomy
- November 20, 2009 - 0661 - Hip Resurfacing
- November 20, 2009 - 0665 - Constraint-Induced Therapy
- November 20, 2009 - 0667 - Esophageal/Airway pH Monitoring
- November 20, 2009 - 0669 - Subtalar Implant for Foot Deformity
- November 20, 2009 - 0670 - Xolair (Omalizumab)
- November 20, 2009 - 0672 - Pamidronate (Aredia)
- November 20, 2009 - 0675 - Bortezomib (Velcade)
- November 20, 2009 - 0677 - Functional Electrical Stimulation and Neuromuscular Electrical Stimulation
- November 20, 2009 - 0678 - Gastric Pacing and Gastric Electrical Stimulation
- November 20, 2009 - 0685 - Bevacizumab (Avastin)
- November 20, 2009 - 0687 - Pemetrexed (Alimta)
- November 20, 2009 - 0688 - Intra-oral Appliances for Headaches and Trigeminal Neuralgia
- November 13, 2009 - 0502 - Nerve Conduction Velocity Studies
- November 6, 2009 - 0004 - Obstructive Sleep Apnea in Adults
- November 6, 2009 - 0070 - Diabetes Tests, Programs, and Supplies
- November 6, 2009 - 0648 - Pervasive Developmental Disorders
- November 6, 2009 - 0649 - Extracorporeal Shock-Wave Therapy for Musculoskeletal Indications and Soft Tissue Injuries
- November 6, 2009 - 0654 - Ventricular Assist Devices
- November 6, 2009 - 0655 - Adalimumab (Humira)
- November 6, 2009 - 0656 - Phototherapy for Acne
- November 6, 2009 - 0657 - Hysteroscopic Tubal Sterilization
- November 6, 2009 - 0683 - Oxaliplatin (Eloxatin)
- October 23, 2009 - 0016 - Back Pain - Invasive Procedures
- October 23, 2009 - 0071 - Positron Emission Tomography
- October 23, 2009 - 0325 - Physical Therapy Services
- October 23, 2009 - 0602 - Thermal Intradiscal Procedures
- October 23, 2009 - 0618 - Brain Natriuretic Peptide Testing
- October 23, 2009 - 0625 - Dysphagia Therapy
- October 23, 2009 - 0633 - Benign Skin Lesion Removal
- October 2, 2009 - 0035 - Influenza Vaccine
- October 2, 2009 - 0170 - Growth Hormone and Growth Hormone-Releasing Hormone
- October 2, 2009 - 0171 - MRI of the Extremities
- October 2, 2009 - 0279 - Magnetic Source Imaging/Magnetoencephalography
- October 2, 2009 - 0352 - Tumor Markers
- October 2, 2009 - 0386 - Breast Transillumination, Electrical Impedance Scanning (EIS), and Breast Elastography
- October 2, 2009 - 0530 - Transvaginal Ultrasonography for Ovarian and Endometrial Cancer Screening
- October 2, 2009 - 0559 - Pulsed Dye Laser Treatment
- October 2, 2009 - 0561 - Celiac Disease Laboratory Testing
- October 2, 2009 - 0569 - Lumbar Traction Devices
- October 2, 2009 - 0577 - Psoriasis: Laser Treatment
- October 2, 2009 - 0578 - Lower Limb Prostheses
- October 2, 2009 - 0582 - Titanium Rib
- October 2, 2009 - 0666 - Teriparatide (Forteo)
- October 2, 2009 - 0715 - Pharmacogenetic Testing
- September 18, 2009 - 0106 - Fetal Echocardiograms
- September 18, 2009 - 0206 - Intravenous Immunoglobulins (IVIG)
- September 18, 2009 - 0227 - BRCA Testing, Prophylactic Mastectomy, and Prophylactic Oophorectomy
- September 18, 2009 - 0244 - Wound Care
- September 18, 2009 - 0264 - Multiple Sclerosis
- September 18, 2009 - 0270 - Proton Beam and Neutron Beam Radiotherapy
- September 18, 2009 - 0528 - Androgens and Anabolic Steroids
- September 18, 2009 - 0529 - Transabdominal Cerclage
- September 18, 2009 - 0539 - Fundus Photography
- September 18, 2009 - 0545 - Electrothermal Arthroscopy
- September 18, 2009 - 0546 - Extracorporeal Membrane Oxygenation (ECMO)
- September 18, 2009 - 0553 - Lead Testing
- September 18, 2009 - 0710 - Actigraphy and Accelerometry
- September 18, 2009 - 0779 - Plerixafor Injection (Mozobil)
- September 4, 2009 - 0492 - Radiofrequency Tumor Ablation
- September 4, 2009 - 0501 - Gonadotropin-Releasing Hormone Analogs and Antagonists
- September 4, 2009 - 0504 - Hyperhidrosis (Hyperhydrosis)
- September 4, 2009 - 0511 - Eating Disorders (Anorexia and Bulimia)
- September 4, 2009 - 0512 - Premenstrual Syndrome/Premenstrual Dysphoric Disorder
- September 4, 2009 - 0517 - Breast Ductal Lavage and Fiberoptic Ductoscopy
- September 4, 2009 - 0518 - Nitric Oxide, Inhalational (INO)
- September 4, 2009 - 0520 - Magnetic Resonance Imaging of the Cardiovascular System - Cardiac MRI
- September 4, 2009 - 0521 - Prostate Cancer Screening
- August 21, 2009 - 0055 - Hematopoietic Colony-Stimulating Factors (CSFs)
- August 21, 2009 - 0113 - Botulinum Toxin
- August 21, 2009 - 0313 - Herceptin (Trastuzumab)
- August 21, 2009 - 0447 - Complex Regional Pain Syndrome (CRPS) / Reflex Sympathetic Dystrophy (RSD): Treatments
- August 21, 2009 - 0449 - Fetal Surgery In Utero
- August 21, 2009 - 0451 - Foot Orthotics
- August 21, 2009 - 0462 - Migraine and Cluster Headache: Nonsurgical Management
- August 21, 2009 - 0464 - Serum Marker Screening for Down Syndrome
- August 21, 2009 - 0465 - Mifepristone (RU 486)
- August 21, 2009 - 0469 - Transcranial Magnetic Stimulation and Cranial Electrical Stimulation
- August 21, 2009 - 0479 - Respiratory Devices: Incentive Spirometers and Intermittent Positive Pressure Breathing Machines
- August 21, 2009 - 0484 - Glaucoma Surgery
- August 21, 2009 - 0500 - Intermittent Pneumatic Compression Devices for the Legs
- August 21, 2009 - 0743 - Spinal Surgery: Laminectomy and Fusion
- August 7, 2009 - 0297 - Cryoanalgesia and Therapeutic Cold
- August 7, 2009 - 0327 - Infertility
- August 7, 2009 - 0381 - Cardiovascular Disease Risk Tests
- August 7, 2009 - 0396 - Gastrointestinal Function: Selected Tests
- August 7, 2009 - 0415 - Optic Nerve Decompression Surgery
- August 7, 2009 - 0419 - Graves' Ophthalmopathy Treatments
- August 7, 2009 - 0422 - Vitiligo
- August 7, 2009 - 0423 - Alopecia Areata
- August 7, 2009 - 0426 - Attention Deficit/Hyperactivity Disorder
- August 7, 2009 - 0431 - Nocturnal Enuresis Treatments
- August 7, 2009 - 0434 - Therapeutic Chairs
- August 7, 2009 - 0443 - Cervical Cancer Screening and Diagnosis
- August 7, 2009 - 0658 - Psoriasis: Biological Therapies
- August 7, 2009 - 0684 - Cetuximab (Erbitux)
- August 7, 2009 - 0693 - Somatostatin Analogs
- August 7, 2009 - 0748 - Panitumumab (Vectibix)
- July 31, 2009 - 0318 - Synagis (Palivizumab) for Prevention of Respiratory Syncytial Virus (RSV) Infections
- July 24, 2009 - 0107 - Chiropractic Services
- July 24, 2009 - 0140 - Genetic Testing
- July 24, 2009 - 0382 - Intravascular Ultrasound
- July 24, 2009 - 0383 - Mohs Micrographic Surgery
- July 24, 2009 - 0388 - Complementary and Alternative Medicine
- July 24, 2009 - 0389 - Hypertrophic Scars and Keloids
- July 24, 2009 - 0394 - Epilepsy Surgery
- July 24, 2009 - 0398 - Idiopathic Scoliosis: Treatments
- July 24, 2009 - 0404 - Interferons
- July 24, 2009 - 0405 - Mechanical Stretching Devices for Contracture and Joint Stiffness
- July 24, 2009 - 0411 - Bone and Tendon Graft Substitutes and Adjuncts
- July 24, 2009 - 0761 - Certolizumab Pegol (Cimzia)
Updated:
- November 20, 2009 - 0660 - Unicompartmental, Bicompartmental, and Bi-unicompartmental Knee Arthroplasties
- November 18, 2009 - 0227 - BRCA Testing, Prophylactic Mastectomy, and Prophylactic Oophorectomy
- November 17, 2009 - 0640 - Bone Marrow or Peripheral Stem Cell Transplant for Acute Lymphocytic Leukemia
- November 17, 2009 - 0641 - Adoptive Immunotherapy
- November 17, 2009 - 0642 - Neuralgia Inducing Cavitational Osteonecrosis (NICO) and Ultrasonograph Bone Densitometer to Detect NICO
- November 17, 2009 - 0644 - Smallpox Vaccine
- November 17, 2009 - 0645 - Total Ankle Arthroplasty
- November 17, 2009 - 0646 - Voice Therapy
- November 17, 2009 - 0647 - Histamine Desensitization Therapy for Intractable Headaches
- November 17, 2009 - 0651 - Endovascular Repair of Aortic Aneurysms
- November 17, 2009 - 0653 - Diphtheria, Tetanus, and Pertussis Vaccines
- November 13, 2009 - 0627 - Allogeneic Bone Marrow or Peripheral Stem Cell Transplant for Aplastic Anemia
- November 13, 2009 - 0628 - Spinal Ultrasound
- November 13, 2009 - 0629 - Bunionectomy
- November 13, 2009 - 0630 - Vacuum Assisted Socket System (VASS)
- November 13, 2009 - 0634 - Non-myeloablative Bone Marrow/Peripheral Stem Cell Transplantation (Mini-Allograft / Reduced Intensity Conditioning Transplant)
- November 13, 2009 - 0636 - Hammertoe Repair
- November 13, 2009 - 0637 - Osteochondral Autografts (Mosaicplasty, OATS)
- November 13, 2009 - 0638 - Donor Lymphocyte Infusion
- November 13, 2009 - 0639 - Autotransfusers
- November 6, 2009 - 0685 - Bevacizumab (Avastin)
- November 3, 2009 - 0609 - Laser Photocoagulation of Drusen
- November 3, 2009 - 0611 - Fecal Incontinence Treatments
- November 3, 2009 - 0612 - Implantable Hearing Aids: Vibrant Soundbridge
- November 3, 2009 - 0613 - Stereolithography
- November 3, 2009 - 0614 - Fetal Striatal Transplantation for Huntington's Disease
- November 3, 2009 - 0616 - Antroduodenal Manometry
- November 3, 2009 - 0619 - Eye Prosthesis
- November 3, 2009 - 0620 - Facial Prostheses, External
- November 3, 2009 - 0621 - Drug-Eluting Stents
- November 3, 2009 - 0623 - Safety Items
- October 30, 2009 - 0592 - Radiofrequency Ablation of Hypertrophied Nasal Turbinates
- October 30, 2009 - 0594 - Visudyne (Verteporfin) Photodynamic Therapy
- October 30, 2009 - 0597 - Heart-Lung Transplant
- October 30, 2009 - 0601 - Pancreas Transplantation Alone (PTA) and Islet Cell Transplantation
- October 30, 2009 - 0603 - Total-Body CT Screening
- October 30, 2009 - 0604 - Infrared Therapy
- October 30, 2009 - 0605 - Intestinal Transplantation
- October 30, 2009 - 0606 - Stem Cell Transplant for Autoimmune Diseases
- October 30, 2009 - 0607 - Anesthetic Infusion Pumps
- October 30, 2009 - 0608 - Salivary Hormone Tests
- October 20, 2009 - 0574 - Female Erectile Devices for the Treatment of Female Sexual Dysfunction (FSD)
- October 20, 2009 - 0576 - Laminoplasty
- October 20, 2009 - 0579 - T-Wave Alternans
- October 20, 2009 - 0580 - Low Vision Programs
- October 20, 2009 - 0581 - Lung Imaging Fluorescence Endoscopy (LIFE)
- October 20, 2009 - 0585 - Cardioverter-Defibrillators
- October 20, 2009 - 0587 - Pancreas Kidney Transplantation
- October 20, 2009 - 0588 - Capsule Endoscopy
- October 20, 2009 - 0590 - Intensity Modulated Radiation Therapy
- October 16, 2009 - 0560 - Voice Prosthesis for Voice Rehabilitation Following Total Laryngectomy
- October 16, 2009 - 0562 - Biochemical Markers of Bone Remodeling for Osteoporosis
- October 16, 2009 - 0563 - Diabetic Retinopathy Telescreening Systems
- October 16, 2009 - 0564 - Electrocochleogram and Perilymphatic Pressure Measurement
- October 16, 2009 - 0565 - Ankle Orthoses, Ankle-Foot Orthoses (AFOs), and Knee-Ankle-Foot Orthoses (KAFOs)
- October 16, 2009 - 0566 - Strabismus Repair in Adults
- October 16, 2009 - 0567 - Actinic Keratoses Treatment
- October 16, 2009 - 0568 - AngioJet Rheolytic Thrombectomy System
- October 16, 2009 - 0570 - Chemotherapy Inpatient
- October 16, 2009 - 0571 - Dehydration Testing for Endolymphatic Hydrops (Meniere's Disease)
- October 16, 2009 - 0572 - Home/Ambulatory Spirometry
- October 2, 2009 - 0195 - Erythropoiesis Stimulating Agents
- October 2, 2009 - 0575 - Intravenous Iron Therapy
- October 2, 2009 - 0583 - Eye Movement Desensitization and Reprocessing (EMDR) Therapy
- September 29, 2009 - 0503 - Suction Pumps
- September 29, 2009 - 0505 - Ambulatory Assist Devices: Walkers, Canes, and Crutches
- September 29, 2009 - 0507 - High-Dose Chemotherapy with Hematopoietic Stem Cell Support for Breast Cancer
- September 29, 2009 - 0509 - Contact Dissolution for Gallstones
- September 29, 2009 - 0510 - Progestins
- September 29, 2009 - 0514 - Meniere's Disease Surgery
- September 29, 2009 - 0515 - Thyrogen (Thyrotropin Alfa)
- September 29, 2009 - 0522 - Pulsed Irrigation Evacuation (PIE)
- September 29, 2009 - 0523 - Car-Ride Simulators for Infantile Colic
- September 25, 2009 - 0490 - Transpupillary Thermal Therapy
- September 25, 2009 - 0491 - Coronary Artery Brachytherapy and Other Adjuncts to Coronary Interventions
- September 25, 2009 - 0493 - Kidney Transplantation
- September 25, 2009 - 0494 - High Dose Chemotherapy with Bone Marrow or Peripheral Stem Cell Transplant for Non-Hodgkin's Lymphoma
- September 25, 2009 - 0495 - High Dose Chemotherapy Bone Marrow or Peripheral Stem Cell Transplant for Hodgkin's Disease
- September 25, 2009 - 0496 - High Dose Chemotherapy and Bone Marrow or Peripheral Stem Cell Transplant for Neuroblastoma
- September 25, 2009 - 0497 - High Dose Chemotherapy with Bone Marrow or Peripheral Stem Cell Transplant for Multiple Myeloma
- September 22, 2009 - 0544 - Immune Globulins for Post-exposure Prophylaxis
- September 22, 2009 - 0547 - Rosacea
- September 22, 2009 - 0549 - Distraction Osteogenesis for Craniofacial Defects
- September 22, 2009 - 0551 - Radiation Treatment of Keloids
- September 22, 2009 - 0552 - Laser Neurolysis
- September 22, 2009 - 0557 - Melanoma Vaccine
- September 22, 2009 - 0558 - Percutaneous Transluminal Septal Myocardial Ablation (PTSMA)
- September 11, 2009 - 0525 - Screening for Lipid Disorders
- September 11, 2009 - 0526 - Surgical Dressings (Wound Care Supplies)
- September 11, 2009 - 0527 - Intragastric Hypothermia
- September 11, 2009 - 0531 - Balloon-Expandable Venous Stents
- September 11, 2009 - 0532 - Scrotal Ultrasonography
- September 11, 2009 - 0534 - Vesicoureteral Reflux Treatment by Endoscopic Injection of Bulking Agents
- September 11, 2009 - 0535 - Virtual Gastrointestinal Endoscopy
- September 11, 2009 - 0536 - Vitamin B-12 Therapy
- September 11, 2009 - 0538 - Endothelial Cell Photography
- September 11, 2009 - 0542 - HIV Testing
- August 28, 2009 - 0475 - Coblation Non-thermal Volumetric Tissue Reduction
- August 28, 2009 - 0476 - Influenza Rapid Diagnostic Tests
- August 28, 2009 - 0477 - Balloon Valvuloplasty
- August 28, 2009 - 0480 - Tourette Syndrome
- August 28, 2009 - 0483 - Anthrax Vaccine
- August 28, 2009 - 0485 - Autonomic Testing / Sudomotor Tests
- August 25, 2009 - 0450 - Fluidized Therapy (Fluidotherapy)
- August 25, 2009 - 0453 - Cervical Traction Devices
- August 25, 2009 - 0456 - Pillows and Cushions
- August 25, 2009 - 0457 - Punctal Occlusion for Dry Eyes
- August 25, 2009 - 0458 - Peripheral Vascular Rehabilitation Programs
- August 25, 2009 - 0466 - Clinical Trials, Coverage of Routine Patient Care Costs
- August 25, 2009 - 0467 - Vestibular Autorotation Test (VAT)
- August 25, 2009 - 0468 - Terbutaline Pump for Preterm Labor
- August 25, 2009 - 0471 - Tuberculosis Testing
- August 25, 2009 - 0472 - Thoracic Electrical Bioimpedance for Cardiac Output Monitoring
- August 25, 2009 - 0473 - Vaccines for Travel
- August 25, 2009 - 0474 - Total Body Plethysmography
- August 4, 2009 - 0438 - Obsolete and Unreliable Tests and Procedures
- August 4, 2009 - 0441 - Ovarian Vein Embolization for Pelvic Congestion Syndrome
- August 4, 2009 - 0442 - Enzyme-replacement Therapy for Lysosomal Storage Disorders
- August 4, 2009 - 0444 - Early Intervention Programs
- August 4, 2009 - 0445 - Electroconvulsive Therapy
- August 4, 2009 - 0446 - Endoscopic Ultrasonography
- July 31, 2009 - 0432 - Computerized Motion Diagnostic Imaging
- July 31, 2009 - 0433 - Chlamydia Trachomatis - Screening and Diagnosis
- July 31, 2009 - 0435 - Viscocanalostomy and Canaloplasty
- July 31, 2009 - 0437 - Speech Generating Devices
- July 28, 2009 - 0412 - Therabite Jaw Motion Rehabilitation System
- July 28, 2009 - 0413 - Percutaneous Embolization of Varicocele
- July 28, 2009 - 0414 - AcuTect Scintigraphic Imaging for Detection of Lower Limb Deep Vein Thrombosis
- July 28, 2009 - 0416 - Nerve Graft During Radical Retropubic Prostatectomy
- July 28, 2009 - 0417 - Amnioinfusion
- July 28, 2009 - 0418 - Myringotomy and Tympanostomy Tube
- July 28, 2009 - 0420 - Balloon Dacryocystoplasty/Dacryoplasty for Nasolacrimal Duct Obstruction
- July 28, 2009 - 0425 - Ambulatory Electroencephalography
- July 28, 2009 - 0427 - Carbon Dioxide Laser for Actinic Lesions of the Skin
- July 28, 2009 - 0428 - Carbogen Inhalation for Sudden Hearing Loss