Periodic Reviews for 2015


Changes to Review Schedule

Please note that the attached document 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hereby assume any obligation to update information presented in this document, so information contained herein may be out of date at any given time.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.


January 8 (1 - 50)
January 22 (55 - 131)
February 12 (132 - 188)
February 26 (189 - 237)
March 12 (238 - 289)
March 26 (290 - 340)
April 9 (341 - 379)

April 23 (380 - 418)
May 14 (419 - 464)
May 28 (465 - 507)
June 11 (508 - 546)
June 25 (547 - 586)
July 9 (587 - 625)
July 23 (626 - 663)

August 13 (664 - 699)
August 27 (700 - 735)
September 10 (736 - 771)
September 24 (772 - 807)
October 8 (808 - 843)
October 22 (844 - )


 Anticipated CPB Review Date: January 8

0001 - Transrectal Ultrasound
0002 - Oxygen
0003 - Apnea Monitors for Infants
0004 - Obstructive Sleep Apnea in Adults
0005 - Septoplasty and Rhinoplasty
0007 - Erectile Dysfunction
0008 - Color-Flow Doppler Echocardiography in Adults
0009 - Orthopedic Casts, Braces and Splints
0010 - Continuous Passive Motion (CPM) Machines
0011 - Electrical Stimulation for Pain
0013 - Cochlear Implants and Auditory Brainstem Implants
0016 - Back Pain - Invasive Procedures
0017 - Breast Reduction Surgery and Gynecomastia Surgery
0019 - Holter Monitors
0020 - Injectable Medications
0021 - Cardiac Rehabilitation
0022 - Calcitriol and Paricalcitol Injections
0023 - Corneal Remodeling
0024 - Interleukin-2 (Aldesleukin, Proleukin, IL-2)
0025 - Automated Ambulatory Blood Pressure Monitoring
0027 - Vasectomy Procedures
0028 - Temporomandibular Disorders
0029 - Thermography
0031 - Cosmetic Surgery
0032 - Pulmonary Rehabilitation
0034 - Aural Rehabilitation
0035 - Influenza Vaccine
0037 - Pneumococcal Vaccine
0038 - Allergy and Hypersensitivity
0039 - Weight Reduction Medications and Programs
0046 - Routine Foot Care
0047 - Prenatal Care Provided by Primary Care Physicians
0048 - Hepatitis A Vaccine
0049 - Nutritional Counseling
0050 - Varicose Veins

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 Anticipated CPB Review Date: January 22

0055 - Hematopoietic Colony-Stimulating Factors (CSFs)
0059 - Peak Flow Meters
0061 - Nutritional Support
0062 - Burn Garments
0065 - Nebulizers
0067 - Chest Physiotherapy and Airway Clearance Devices
0069 - Lymphedema
0070 - Diabetes Tests, Programs and Supplies
0071 - Positron Emission Tomography (PET)
0073 - Cardiac Event Monitors
0078 - Learning Disabilities, Dyslexia, and Vision
0079 - Benign Prostatic Hypertrophy (BPH) Treatments
0082 - Dental Services and Oral and Maxillofacial Surgery: Coverage Under Medical Plans
0083 - Stereotactic Radiosurgery
0084 - Ptosis Surgery
0088 - Antepartum Fetal Surveillance
0091 - Endometrial Ablation
0093 - Open Air, Low Field Strength, and Positional MRI Units
0094 - Magnetic Resonance Angiography (MRA) and Magnetic Resonance Venography (MRV)
0095 - Orthognathic Surgery
0097 - External Breast Prosthesis
0100 - Cryoablation
0105 - Magnetic Resonance Imaging (MRI) of the Breast
0106 - Fetal Echocardiograms
0107 - Chiropractic Services
0111 - Indocyanine Green Angiography
0112 - Surface Scanning and Macro Electromyography
0113 - Botulinum Toxin
0115 - Varicella and Herpes Zoster Vaccines
0116 - Frenectomy or Frenotomy for Ankyloglossia
0124 - General Anesthesia and Monitored Anesthesia Care for Oral and Maxillofacial Surgery and Dental Services
0126 - Contact Lenses and Eyeglasses
0127 - Home Uterine Activity Monitoring
0130 - Computerized Corneal Topography
0131 - Clotting Factors

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 Anticipated CPB Review Date: February 12

0132 - Biofeedback
0134 - Bone Mass Measurements
0135 - Acupuncture
0136 - Skilled Home Private Duty Nursing Care
0140 - Genetic Testing
0142 - Breast Implant Removal
0145 - Alpha 1-Antitrypsin Inhibitor Therapy
0147 - Reflex Sympathetic Dystrophy Diagnosis
0151 - Hippotherapy
0153 - Thalamotomy
0155 - Ribavirin (Virazole)
0157 - Obesity Surgery
0158 - Neuropsychological and Psychological Testing
0160 - Lung Volume Reduction Surgery
0161 - Infusion Pumps
0163 - Transmyocardial and Endovascular Laser Revascularization
0165 - Cardiac Catheter Ablation Procedures
0166 - Fetal Fibronectin, Inflammatory Biomarkers, and Salivary Estriol Testing for Preterm Labor
0168 - Tumor Scintigraphy
0169 - Outpatient Medical Self-Care Programs
0170 - Growth Hormone (GH) and Growth Hormone Antagonists
0171 - MRI of the Extremities
0172 - Hyperbaric Oxygen Therapy (HBOT)
0173 - Prothrombin Time (INR) Home Testing Devices
0174 - Pool Therapy, Aquatic Therapy or Hydrotherapy
0175 - High-Frequency Pulsed Electromagnetic Stimulation
0177 - Helicobacter pylori Infection Testing
0179 - Viscosupplementation
0180 - Vertebral Axial Decompression
0181 - Evoked Potential Studies
0182 - Ventricular Remodeling Operation (Batista Procedure) / and Surgical Ventricular Restoration (Dor Procedure)
0184 - Pulmonary Hypertension Treatments and Selected Indications of Prostanoids
0185 - Breast Reconstructive Surgery
0188 - Total Body Photography and Dermoscopy

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 Anticipated CPB Review Date: February 26

0189 - Genetic Counseling
0190 - Stem Cells for Bone Marrow Transplant
0191 - Vagus Nerve Stimulation
0194 - Dorsal Column Stimulation
0195 - Erythropoesis Stimulating Agents
0198 - Work Hardening Programs
0199 - Ultrasound for Pregnancy
0200 - Coumadin (Warfarin) To Heparin Conversion Before And After Elective Surgery
0201 - Skilled Home Health Care Nursing Services
0202 - Magnetic Resonance Spectroscopy (MRS)
0204 - Manipulation Under General Anesthesia
0205 - Phototherapy and Photochemotherapy (PUVA) for Skin Conditions
0206 - Parenteral Immunoglobulins
0207 - Prolotherapy
0208 - Deep Brain Stimulation
0210 - Phonophoresis
0211 - Abdominoplasty,Suction Lipectomy, and Ventral Hernia Repair
0212 - Skeletal Analysis Systems
0213 - Gastroesophageal Reflux Disease (GERD): Treatment Devices
0214 - Cognitive Rehabilitation
0215 - Lyme Disease and other Tick-Borne Diseases
0218 - Home Health Aides
0220 - Distraction Osteosynthesis
0221 - Quantitative EEG (Brain Mapping)
0223 - Urinary Incontinence Treatments
0225 - Maze Procedure
0226 - Hospitalization for the Initiation of Ketogenic Diet for the Treatment of Intractable Seizures
0227 - BRCA Testing, Prophylactic Mastectomy, and Prophylactic Oophorectomy
0228 - Cardiac CT, Coronary CT Angiography and Calcium Scoring
0229 - Iontophoresis
0231 - Grenz Ray Therapy for Skin Disorders
0232 - Back Pain - Non Invasive Treatments
0234 - Chelation Therapy
0235 - Plantar Fasciitis Treatments
0236 - MRI and CT of the Spine
0237 - Chronic Pain Programs

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 Anticipated CPB Review Date: March 12

0238 - Chronic Vertigo
0240 - Antineoplaston Therapy and Sodium Phenylbutyrate
0241 - Extracorporeal Photochemotherapy (Photopheresis)
0243 - Speech Therapy
0244 - Wound Care
0245 - Tumor Chemosensitivity Assays
0247 - Autologous Chondrocyte Implantation
0248 - Fiberoptic Endoscopic Evaluation of Swallowing (FEES)/Fiberoptic Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST)
0249 - Inflammatory Bowel Disease: Serologic Markers and Pharmacogenomic and Metabolic Assessment of Thiopurine Therapy
0250 - Occupational Therapy Services
0251 - Dermabrasion, Chemical Peels, and Acne Surgery
0253 - Vocal Cord Paralysis/Insufficiency Treatments
0255 - Inpatient Admission Prior to Surgery (Preop Days)
0256 - Sensory and Auditory Integration Therapy
0259 - Transjugular Intrahepatic Portosystemic Shunt (TIPSS)
0262 - External Counterpulsation (ECP)
0263 - Gait Analysis and Electrodynogram
0264 - Multiple Sclerosis
0265 - Surgical Treatments to Control Drooling (Sialorrhea)
0266 - Cholecystokinin Cholescintigraphy
0267 - Ornish Cardiac Treatment Program
0268 - Liver and Other Neoplasms - Treatment Approaches
0269 - Breast Biopsy Procedures
0270 - Proton Beam and Neutron Beam Radiotherapy
0271 - Wheelchairs and Power Operated Vehicles (Scooters)
0272 - Pectus Excavatum and Poland's Syndrome: Surgical Correction
0274 - Ablation of Hepatic Lesions
0276 - Angioplasty and Stenting of Extra-Cranial and Intra-Cranial Arteries
0278 - Hyperthermia in Cancer Therapy
0279 - Magnetic Source Imaging/Magnetoencephalography
0282 - Noninvasive Down Syndrome Screening
0284 - Melodic Intonation Therapy
0285 - Plasmapheresis/Plasma Exchange/Therapeutic Apheresis
0287 - Total Hip Replacement
0288 - Stereotactic Cingulotomy
0289 - Grid Monitoring and Intraoperative Electroencephalography

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 Anticipated CPB Review Date: March 26

0290 - Scalp Cooling (Hypothermia) to Prevent Hair Loss During Chemotherapy
0291 - Hemodialysis for Schizophrenia
0292 - Transcatheter Closure of Septal Defects
0293 - Corneal Graft with Amniotic Membrane Transplantation and Limbal Stem Cell Transplantation
0294 - Pedobarography
0295 - Peripheral Atherectomy and Thrombectomy Devices
0297 - Cryoanalgesia and Therapeutic Cold
0298 - Non-invasive Negative Pressure Ventilation: Body Ventilators and Poncho Wrap
0299 - Tilt Table Testing
0300 - Hair Analysis
0302 - Electrical Stimulation for Xerostomia
0304 - Fibroid Treatment
0305 - Videostroboscopy
0306 - Dexamethasone Suppression Test for Diagnosing Depression
0307 - Parkinson's Disease
0310 - Thoracoscopic Sympathectomy
0313 - Trastuzumab (Herceptin), Ado-Trastuzumab (Kadcyla) and Pertuzumab (Perjeta)
0314 - Rituximab (Rituxan)
0315 - Enbrel (Etanercept)
0316 - HIV Drug Susceptibility and Resistance Tests
0317 - Ultra Rapid Detoxification (UROD)
0318 - Synagis (Palivizumab) for Prevention of Respiratory Syncytial Virus (RSV) Infections
0319 - RET Proto-Oncogene Testing
0321 - Visual Perceptual Training/Vision Restoration Therapy
0322 - Electroencephalographic (EEG) Video Monitoring
0323 - Preconceptional Sex Selection Techniques
0325 - Physical Therapy Services
0327 - Infertility
0329 - Home Births
0330 - Multiple Sleep Latency Test (MSLT)
0332 - Neonatal Hyperbilirubinemia
0334 - Negative Pressure Wound Therapy
0336 - Acoustic Pharyngometers and SNAP™ Testing System
0337 - BreastCare/BreastAlert Differential Temperature Sensor
0339 - Pulse Oximetry for Home Use
0340 - Antibody Tests for Neurologic Diseases

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 Anticipated CPB Review Date: April 9

0341 - Remicade (infliximab)
0342 - Intestinal Rehabilitation Programs
0343 - Bone Growth Stimulators
0344 - Optic Nerve and Retinal Imaging Methods
0345 - Implantable Hormone Pellets
0346 - Low-Molecular-Weight Heparins and Thrombin Inhibitors
0347 - Transcervical Balloon Tuboplasty
0348 - Recurrent Pregnancy Loss
0349 - Alzheimer's Disease
0351 - Flow Cytometry, DNA Ploidy, and S-phase Fraction
0352 - Tumor Markers
0353 - Transcranial Doppler Ultrasonography
0354 - YAG Laser in Ophthalmology: Selected Indications
0355 - Extracorporeal Immunoadsorption (Prosorba column)
0356 - Meningococcal Vaccine
0357 - Quantitative Sensory Testing Methods
0358 - Invasive Prenatal Diagnosis of Genetic Diseases
0361 - Radiopharmaceuticals Metastron® (Strontium-89) and Samarium-153 (Quadramet) for Metastatic Bone Pain
0362 - Spasticity Management
0363 - Cold Laser and High-Power Laser Therapies
0364 - Allograft Transplants of the Extremities
0365 - Pancreaticoduodenectomy (Whipple Resection) for Zollinger-Ellison Syndrome
0366 - Paralytic Lagophthalmos: Treatments
0367 - Home Cholesterol Monitors
0368 - Obstetrical Hypertension Programs
0369 - Chronic Fatigue Syndrome
0370 - Phototherapy for Psychiatric Disorders
0371 - Brachytherapy
0372 - Noncontact Normothermic/Nonthermal Wound Therapy
0373 - Crit-Line In-Line Monitor
0374 - Trigeminal Neuralgia Procedures
0375 - Photodynamic Therapy
0376 - Single Photon Emission Computed Tomography (SPECT)
0377 - Dendritic Cell Immunotherapy
0378 - NeuroControl Freehand System
0379 - Cranial Remodeling

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 Anticipated CPB Review Date: April 23

0380 - Lung Cancer Screening
0381 - Cardiovascular Disease Risk Tests
0382 - Intravascular Ultrasound
0383 - Mohs Micrographic Surgery
0384 - Magnetic Resonance Cholangiopancreatography
0386 - Breast Transillumination, Electrical Impedance Scanning (EIS), and Elastography
0387 - Magnetic Resonance Neurography
0388 - Complementary and Alternative Medicine
0389 - Hypertrophic Scars and Keloids
0390 - Smell and Taste Disorders - Diagnosis
0392 - Metabolic and Environmental Profiling and Imaging for Kidney Stone Risk
0393 - Vitrectomy
0394 - Epilepsy Surgery
0395 - Ethanol Injection for Thyroid Lesions
0396 - Gastrointestinal Function: Selected Tests
0397 - Knee Ligament Arthrometer Testing
0398 - Idiopathic Scoliosis
0399 - Myoelectric Upper Limb Prostheses
0400 - Ernest or Eagle’s Syndrome (Stylomandibular Ligament Pain): Treatment with Radiofrequency Thermoneurolysis
0401 - Selective Peripheral Denervation (Bertrand Procedure) for Spasmodic Torticollis
0402 - Polio Vaccine
0403 - Bone-Anchored Hearing Aid
0404 - Interferons
0405 - Mechanical Stretching Devices for Contracture and Joint Stiffness
0406 - Tinnitus Treatments
0407 - Selected Aortic Valve Procedures: Ross Pulmonary Autograft and Aortic Valve-Sparing Re-implantation
0409 - Macular / Foveal Translocation
0410 - Hepatitis B Vaccine
0411 - Bone and Tendon Graft Substitutes and Adjuncts
0412 - Therabite Jaw Motion Rehabilitation Systems
0413 - Varicocele: Selected Treatments
0414 - AcuTect Scintigraphic Imaging for Detection of Lower Limb Deep Vein Thrombosis
0415 - Optic Nerve Decompression Surgery
0416 - Nerve Grafting: Selected Indications
0417 - Amnioinfusion
0418 - Myringotomy and Tympanostomy Tube

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 Anticipated CPB Review Date: May 14

0419 - Graves' Ophthalmopathy Treatments
0420 - Balloon Dacryocystoplasty / Dacryoplasty for Nasolacrimal Duct Obstruction
0421 - Breast Pumps
0422 - Vitiligo
0423 - Alopecia Areata
0425 - Ambulatory Electroencephalography
0426 - Attention Deficit/Hyperactivity Disorder
0427 - Carbon Dioxide Laser for Actinic Lesions of the Skin
0428 - Carbogen Inhalation Therapy
0429 - Bathroom and Toilet Equipment and Supplies
0430 - Pressure Reducing Support Surfaces
0431 - Nocturnal Enuresis Treatments
0432 - Computerized Motion Diagnostic Imaging
0433 - Chlamydia Trachomatis - Screening and Diagnosis
0434 - Therapeutic Chairs
0435 - Viscocanalostomy and Canaloplasty
0437 - Speech Generating Devices
0438 - Obsolete and Unreliable Tests and Procedures
0441 - Ovarian Vein Embolization for Pelvic Congestion Syndrome
0442 - Enzyme-replacement Therapy for Lysosomal Storage Disorders
0443 - Cervical Cancer Screening and Diagnosis
0444 - Early Intervention Programs
0445 - Electroconvulsive Therapy
0446 - Endoscopic Ultrasonography
0447 - Complex Regional Pain Syndrome (CRPS) / Reflex Sympathetic Dystrophy (RSD): Treatments
0449 - Fetal Surgery In Utero
0450 - Fluidized Therapy (Fluidotherapy)
0451 - Foot Orthotics
0452 - Noninvasive Positive Pressure Ventilation
0453 - Cervical Traction Devices
0456 - Pillows and Cushions
0457 - Dry Eyes
0458 - Peripheral Vascular Rehabilitation Programs
0459 - Seat Lifts and Patient Lifts
0462 - Migraine and Cluster Headache: Nonsurgical Management
0464 - Serum Marker Screening for Down Syndrome

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 Anticipated CPB Review Date: May 28

0465 - Mifepristone (RU 486)
0466 - Clinical Trials, Coverage of Routine Patient Care Costs
0467 - Vestibular Autorotation Test (VAT)
0468 - Terbutaline Pump for Preterm Labor
0469 - Transcranial Magnetic Stimulation and Cranial Electrical Stimulation
0471 - Tuberculosis Testing
0472 - Thoracic Electrical Bioimpedance for Cardiac Output Monitoring
0473 - Vaccines for Travel
0474 - Total Body Plethysmography
0475 - Coblation Non-thermal Volumetric Tissue Reduction
0476 - Influenza Rapid Diagnostic Tests
0477 - Balloon Valvuloplasty
0479 - Respiratory Devices: Incentive Spirometers and Intermittent Positive Pressure Breathing Machines
0480 - Tourette Syndrome
0481 - Tables and Boards
0482 - Compression Garments for the Legs
0483 - Anthrax Vaccine/Treatment
0484 - Glaucoma Surgery
0485 - Autonomic Testing / Sudomotor Tests
0489 - Vision Therapy
0490 - Transpupillary Thermal Therapy
0491 - Coronary Artery Brachytherapy and Other Adjuncts to Coronary Interventions
0492 - Radiofrequency Tumor Ablation
0493 - Kidney Transplantation
0494 - Hematopoietic Cell Transplantation for Non-Hodgkin's Lymphoma
0495 - Hematopoietic Cell Transplantation for Hodgkin's Disease
0496 - High Dose Chemotherapy and Bone Marrow or Peripheral Stem Cell Transplant for Selected Childhood Solid Tumors
0497 - Hematopoietic Cell Transplantation for Multiple Myeloma
0500 - Intermittent Pneumatic Compression Devices
0501 - Gonadotropin-Releasing Hormone Analogs and Antagonists
0502 - Nerve Conduction Velocity Studies
0503 - Suction Pumps
0504 - Hyperhidrosis (Hyperhydrosis)
0505 - Ambulatory Assist Devices: Walkers, Canes, and Crutches
0507 - Hematopoietic Cell Transplantation for Breast Cancer

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 Anticipated CPB Review Date: June 11

0508 - Cataract Removal Surgery
0509 - Contact Dissolution for Gallstones
0510 - Progestins
0511 - Eating Disorders
0512 - Premenstrual Syndrome/Premenstrual Dysphoric Disorder
0514 - Meniere's Disease Surgery
0515 - Thyrogen (Thyrotropin Alfa)
0516 - Colorectal Cancer Screening
0517 - Breast Ductal Lavage and Fiberoptic Ductoscopy
0518 - Nitric Oxide, Inhalational (INO)
0520 - Magnetic Resonance Imaging of the Cardiovascular System - Cardiac MRI
0521 - Prostate Cancer Screening
0522 - Pulsed Irrigation Evacuation (PIE)
0523 - Car-Ride Simulators for Infantile Colic
0524 - Zoledronic Acid
0525 - Screening for Lipid Disorders
0526 - Surgical Dressings (Wound Care Supplies)
0527 - Intragastric Hypothermia
0528 - Androgens and Anabolic Steroids
0529 - Transabdominal Cerclage
0530 - Transvaginal Ultrasonography for Ovarian and Endometrial Cancer Screening and Other Selected Indications
0531 - Balloon-Expandable Venous Stents
0532 - Scrotal Ultrasonography
0533 - Urological Supplies
0534 - Vesicoureteral Reflux Treatment by Endoscopic Injection of Bulking Agents
0535 - Virtual Gastrointestinal Endoscopy
0536 - Vitamin B-12 Therapy
0538 - Endothelial Cell Photography
0539 - Fundus Photography
0540 - Heating Devices
0541 - Home Dialysis
0542 - HIV Testing
0543 - Hospital Beds and Accessories
0544 - Immune Globulins for Post-exposure Prophylaxis
0545 - Electrothermal Arthroscopy
0546 - Extracorporeal Membrane Oxygenation (ECMO)

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 Anticipated CPB Review Date: June 25

0547 - Rosacea
0548 - Cardiovascular Monitoring Equipment for Home Use: Pulse, Blood Pressure, Telemonitors, and Pacemaker Monitors
0549 - Distraction Osteogenesis for Craniofacial Defects
0551 - Radiation Treatment for Selected Nononcologic Indications
0552 - Laser Neurolysis
0553 - Lead Testing
0556 - Bio-Surgery: Medicinal Leech Therapy and Medical Maggots
0557 - Cancer Vaccines
0558 - Percutaneous Transluminal Septal Myocardial Ablation (PTSMA)
0559 - Pulsed Dye Laser Treatment
0560 - Voice Prosthesis for Voice Rehabilitation Following Total Laryngectomy
0561 - Celiac Disease Laboratory Testing
0562 - Biochemical Markers of Bone Remodeling
0563 - Retinopathy Telescreening Systems
0564 - Electrocochleogram and Perilymphatic Pressure Measurement
0565 - Ankle Orthoses, Ankle-Foot Orthoses (AFOs), and Knee-Ankle-Foot Orthoses (KAFOs)
0566 - Strabismus Repair in Adults
0567 - Actinic Keratoses Treatment
0568 - AngioJet Rheolytic Thrombectomy System
0569 - Lumbar Traction Devices
0570 - Chemotherapy Inpatient
0571 - Dehydration Testing for Endolymphatic Hydrops (Meniere's Disease)
0572 - Home/Ambulatory Spirometry
0574 - Female Sexual Dysfunction (FSD)
0575 - Intravenous Iron Therapy
0576 - Laminoplasty
0577 - Laser Treatment for Psoriasis and Other Selected Skin Conditions
0578 - Lower Limb Prostheses
0579 - T-Wave Alternans
0580 - Low Vision Programs
0581 - Lung Imaging Fluorescence Endoscopy (LIFE)
0582 - Titanium Rib
0583 - Eye Movement Desensitization and Reprocessing (EMDR) Therapy
0584 - Mammography
0585 - Cardioverter-Defibrillators
0586 - Heart Transplantation

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 Anticipated CPB Review Date: July 9

0587 - Pancreas Kidney Transplantation
0588 - Capsule Endoscopy
0590 - Intensity Modulated Radiation Therapy
0591 - Intervertebral Disc Prostheses
0592 - Radiofrequency Ablation of Hypertrophied Nasal Turbinates
0593 - Aerosolized or Irrigated Anti-infectives for Sinusitis
0594 - Visudyne (Verteporfin) Photodynamic Therapy
0595 - Kineret (Anakinra)
0596 - Liver Transplantation
0597 - Heart-Lung Transplant
0598 - Lung Transplantation
0599 - Autologous Skeletal Myoblast/Mononuclear Bone Marrow Cell Transplantation for Cardiac Diseases
0601 - Pancreas Transplantation Alone and Islet Cell Transplantation
0602 - Thermal Intradiscal Procedures
0603 - Total-Body CT Screening
0604 - Infrared Therapy
0605 - Intestinal Transplantation
0606 - Hematopoietic Cell Transplantation for Autoimmune Diseases and Miscellaneous Indications
0607 - Anesthetic and Antiemetic Infusion Pumps
0608 - Salivary Hormone Tests
0609 - Laser Photocoagulation of Drusen
0610 - Biventricular Pacing (Cardiac Resynchronization Therapy)/Combination Resynchronization-Defibrillation Devices for Congestive Heart Failure
0611 - Fecal Incontinence Treatments
0612 - Implantable Hearing Aids
0613 - Stereolithography
0614 - Huntington's Disease
0615 - Gender Reassignment Surgery
0616 - Antroduodenal Manometry
0617 - High Dose Chemotherapy Bone Marrow or Peripheral Stem Cell Transplant for Testicular Cancer
0618 - Brain Natriuretic Peptide Testing
0619 - Eye Prosthesis
0620 - Facial Prostheses, External
0621 - Drug-Eluting Stents
0622 - Glaucoma Testing
0623 - Safety Items
0625 - Dysphagia Therapy

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 Anticipated CPB Review Date: July 23

0626 - Allogeneic Bone Marrow or Peripheral Stem Cell Transplant for Thalassemia Major and Sickle Cell Anemia
0627 - Hematopoietic Cell Transplantation for Aplastic Anemia and other Bone Marrow Failure Syndromes
0628 - Spinal Ultrasound
0629 - Bunionectomy
0630 - Elevated Vacuum Systems
0633 - Benign Skin Lesion Removal
0634 - Non-myeloablative Bone Marrow/Peripheral Stem Cell Transplantation (Mini-Allograft / Reduced Intensity Conditioning Transplant)
0635 - High Dose Chemotherapy Bone Marrow or Peripheral Stem Cell Transplant for Ovarian Cancer
0636 - Hammer Toe Repair
0637 - Osteochondral Autografts (Mosaicplasty, OATS)
0638 - Donor Lymphocyte Infusion
0639 - Autotransfusers
0640 - Bone Marrow or Peripheral Stem Cell Transplant for Selected Leukemias
0641 - Adoptive Immunotherapy and Cellular Therapy
0642 - Neuralgia Inducing Cavitational Osteonecrosis (NICO) and Ultrasonograph Bone Densitometer to Detect NICO
0643 - Diagnosis of Vaginitis
0644 - Smallpox Vaccine
0645 - Total Ankle Arthroplasty
0646 - Voice Therapy
0647 - Histamine Desensitization Therapy for Intractable Headaches
0648 - Pervasive Developmental Disorders
0649 - Extracorporeal Shock-Wave Therapy for Musculoskeletal Indications
0650 - Polymerase Chain Reaction Testing: Selected Indications
0651 - Endovascular Repair of Aortic Aneurysms
0652 - Therapeutic Phlebotomy
0653 - Diphtheria, Tetanus, and Pertussis Vaccines
0654 - Ventricular Assist Devices
0655 - Adalimumab (Humira)
0656 - Phototherapy for Acne
0657 - Tubal Sterilization
0658 - Psoriasis and Psoriatic Arthritis: Biological Therapies
0659 - Radioimmunotherapy for Non-Hodgkin's Lymphoma: Ibritumomab Tiuxetan (Zevalin) and Tositumomab (Bexxar)
0660 - Unicompartmental, Bicompartmental, and Bi-unicompartmental Knee Arthroplasties
0661 - Hip and Shoulder Resurfacing
0662 - Antiprothrombin Antibody Testing
0663 - Cerebral Perfusion Studies

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 Anticipated CPB Review Date: August 13

0664 - Signal-Averaged Electrocardiography (SAECG)
0665 - Constraint-Induced Therapy
0666 - Teriparatide (Forteo)
0667 - Esophageal pH Monitoring
0668 - Auditory Processing Disorder (APD)
0669 - Subtalar Implant for Foot Deformity
0670 - Xolair (Omalizumab)
0671 - Enfuvirtide (Fuzeon)
0672 - Pamidronate (Aredia)
0673 - Osteoarthritis of the Knee: Selected Treatments
0674 - High Dose Chemotherapy/Bone Marrow or Peripheral Stem Cell Transplantation for Chronic Myelogenous Leukemia
0675 - Bortezomib (Velcade)
0676 - Electrical Stimulation for Nausea, Vomiting and Motion Sickness (PrimaBella and ReliefBand)
0677 - Functional Electrical Stimulation and Neuromuscular Electrical Stimulation
0678 - Gastric Pacing / Gastric Electrical Stimulation
0679 - Levator Syndrome Treatments
0680 - Electrical Stimulation for Chronic Ulcers
0681 - Corneal Pachymetry
0682 - Microwave Thermotherapy for Breast Cancer
0683 - Oxaliplatin (Eloxatin)
0684 - Cetuximab (Erbitux)
0685 - Bevacizumab (Avastin)
0686 - Oral Brush Biopsy
0687 - Pemetrexed (Alimta)
0688 - Intra-oral Appliances for Headaches
0689 - Ocular Photoscreening
0690 - Noninvasive Tests for Hepatic Fibrosis
0691 - Breath Tests of Airway Inflammation: Exhaled Nitric Oxide and Exhaled Breath Condensate pH
0692 - Acoustic Heart Sound Recording and Computer Analysis
0693 - Somatostatin Analogs
0694 - Paranasal Sinus Ultrasound for the Evaluation of Sinusitis
0695 - Broth Culture Testing for Interstitial Cystitis
0696 - Suit Therapy
0697 - Intraoperative Electromyographic Monitoring
0698 - Prostate Saturation Biopsy
0699 - Dry Hydrotherapy (Hydromassage, Aquamassage, Water Massage)

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 Anticipated CPB Review Date: August 27

0700 - Rhinometry and Rhinomanometry
0701 - Vascular Endothelial Growth Factor Inhibitors for Ocular Neovascularization
0702 - Abdominal Aortic Aneurysm Screening
0703 - Near-Infrared Spectroscopy and Thermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow
0704 - Indirect Measurement of Left Ventricular Filling Pressure (LVFP): The VeriCor System
0705 - Body Surface Potential Mapping
0706 - Anecortave Acetate (Retaane)
0707 - Headaches: Invasive Procedures
0708 - Metatarsal Phalangeal Joint Replacement
0709 - Nesiritide (Natrecor)
0710 - Actigraphy and Accelerometry
0711 - Insulin-Like Growth Factor-1 (IGF-1) Analogues: Mecasermin (Increlex) and Mecasermin Rinfabate (Iplex)
0712 - Ziconotide (Prialt)
0713 - Artificial Retina
0714 - Re-breathing of Inert Gas for Measurement of Cardiac Output
0715 - Pharmacogenetic Testing
0716 - Sialolithiasis (Salivary Stones)
0717 - Analysis of Volatile Organic Compounds to Detect Bacteriuria
0718 - Defecography
0719 - Retisert (Fluocinolone Acetonide Intra-vitreal Implant)
0720 - Abatacept (Orencia)
0721 - Intraoperative Radiation Therapy (IORT)
0722 - Selective Nerve Root Blocks
0723 - Rotavirus Vaccine
0724 - Antiemetic Injection Therapy
0725 - Post-Herpetic Neuralgia
0726 - Human Papillomavirus (HPV) Vaccines
0727 - Ibandronate Sodium (Boniva) Injection
0728 - Barrett’s Esophagus
0729 - Diabetic Neuropathy: Selected Treatments
0730 - Home Behavioral Healthcare Services
0731 - Convection-Enhanced Intraparenchymal Delivery of Drugs to the Brain
0732 - Guillain-Barre Syndrome Treatments
0733 - Discography
0734 - External Ocular Photography
0735 - Pulsed Radiofrequency

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 Anticipated CPB Review Date: September 10

0736 - Femoro-Acetabular Surgery for Hip Impingement Syndrome
0737 - Double Balloon Enteroscopy
0738 - Upper Gastrointestinal Endoscopy
0739 - Functional Magnetic Resonance Imaging
0740 - Pralatrexate (Folotyn)
0741 - Peripheral Ultrafiltration for Acute Decompensated Heart Failure
0742 - Intermittent Intravenous Insulin Therapy
0743 - Spinal Surgery: Laminectomy and Fusion
0744 - Bronchial Thermoplasty
0745 - Bell's Palsy
0746 - Ultrasound Therapy for Wound Healing
0747 - Transanal Endoscopic Microsurgery for Rectal Cancer
0748 - Panitumumab (Vectibix)
0749 - Anterior Segment Optical Coherence Tomography
0750 - Athletic Pubalgia Surgery
0751 - Natalizumab (Tysabri)
0752 - Obstructive Sleep Apnea in Children
0753 - Core Decompression for Avascular Necrosis
0754 - Laparoscopic Uterine Nerve Ablation (LUNA) and Presacral Neurectomy (PSN)
0755 - Motor Cortex Stimulation
0756 - Epiretinal Radiation Therapy
0757 - AmniSure ROM (Rupture of Membranes) Test
0758 - Tumor Chemoresistance Assays
0759 - Vulvodynia and Vulvar Vestibulitis Treatments
0760 - Oral Screening and Lesion Identification Systems
0761 - Certolizumab Pegol (Cimzia)
0762 - Repository Corticotropin Injection (H.P. Acthar Gel)
0763 - Homocysteine Testing
0764 - Alemtuzumab (Campath)
0765 - Age-Related Macular Degeneration: Treatments
0766 - High Intensity Focused Ultrasound
0767 - Extended Ophthalmoscopy
0768 - Romiplostim (Nplate)
0769 - Endometrial Cancer Screening and Diagnosis
0770 - Cryopyrin-Associated Periodic Syndromes: Treatments
0771 - Procalcitonin (PCT)

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 Anticipated CPB Review Date: September 24

0772 - Axial Lumbar Interbody Fusion (AxiaLIF)
0773 - ImmuKnow (Transplantation Immune Cell Function Assay)
0774 - Nerve Fiber Density Measurement
0775 - RenalVysion
0776 - Electromagnetic Navigation-guided Bronchoscopy
0777 - Suprachoroidal Injection of Pharmacologic Agents
0778 - Robotic-assisted Rehabilitation of the Extremities
0779 - Plerixafor Injection (Mozobil)
0780 - ADAMTS13 Assay for Thrombotic Thrombocytopenic Purpura (TTP)
0781 - Interstitial Laser Therapy
0782 - Hereditary Angioedema
0783 - In Vivo Analysis of Colorectal Polyps and Crohn's Disease
0784 - Blood Product Injections for Selected Indications
0785 - Peripheral Vascular Stents
0786 - Menaflex
0787 - Comparative Genomic Hybridization (CGH)
0788 - Alzheimer's Disease: Experimental Treatments
0789 - Acute Ischemic Stroke: Treatments
0790 - Golimumab (Simponi)
0791 - Cardiac Devices for Occlusion of the Left Atrial Appendage
0792 - Human Fibrinogen Concentrate (RiaSTAP)
0793 - Esophageal Doppler Monitoring
0794 - Ofatumumab (Arzerra)
0795 - Ozurdex (Dexamethasone Intravitreal Implant)
0796 - Near-Infrared (NIR) Spectroscopy
0797 - Evacuation of Meibomian Glands
0798 - Distal Interphalangeal (DIP), Metacarpophalangeal (MCP) and Proximal Interphalangeal (PIP) Joint Implants
0799 - Tocilizumab (Actemra)
0800 - Dupuytren's Contracture: Treatments
0801 - Intra-coronary Hyperoxemic Therapy
0802 - Prostate Cancer Vaccine
0803 - Calcitonin Injection
0804 - Denosumab (Prolia and Xgeva)
0805 - Pudendal Nerve Decompression
0806 - Cabazitaxel (Jevtana)
0807 - Eculizumab (Soliris)

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 Anticipated CPB Review Date: October 8

0808 - High-Resolution Anoscopy
0809 - Pediatric Intensive Feeding Programs
0810 - Gout
0811 - Hematopoietic Stem Cell Transplant for Solid Tumors in Adults
0812 - Hypoxic Ischemic Encephalopathy
0813 - Computerized Wheeze Detectors
0814 - Remote Ischemic Conditioning
0815 - Ipilimumab (Yervoy)
0816 - Hand Transplantation
0817 - Propranolol for Infantile Hemangioma
0818 - Belimumab (Benlysta)
0819 - Face Transplantation
0820 - Carotid Sinus Stimulation for Hypertension
0821 - Transcatheter Pulmonary Valve Implantation
0822 - Internal Fixation of Rib Fracture
0823 - Brentuximab (Adcetris)
0824 - Home Hemoglobin Testing Devices
0825 - Cardiopulmonary Exercise Testing
0826 - Transcatheter Aortic Valve Implantation
0827 - Electric Tumor Treatment Fields
0828 - Irreversible Electroporation (NanoKnife)
0829 - Intra-vascular Optical Coherence Tomography
0830 - Stem Cell Transplantation for Primary Immunodeficiency Disorders
0831 - Eribulin Mesylate (Halaven)
0832 - Implantable Left Atrial Hemodynamic Monitor
0833 - Stem Cell Transplantation to Waldenstrom Macroglobulinemia
0834 - Paclitaxel, Albumin-Bound (Abraxane)
0835 - Hepatitis Screening
0836 - Stem Cell Transplant for Myelodysplastic Syndrome
0837 - Shoulder Arthroplasty
0838 - Stem Cell Transplantation for Myelofibrosis
0839 - Tofacitinib (Xeljanz)
0840 - Devices for Post-Operative Use Following Endoscopic Sinus Surgery
0841 - Non-invasive Measurement of Advanced Glycation End-products in the Skin
0842 - Ziv-Aflibercept (Zaltrap)
0843 - Focal Laser Ablation for the Treatment of Prostate Cancer

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 Anticipated CPB Review Date: October 22

0844 - Fecal Microbiota Transplantation
0845 - Carfilzomib (Kyprolis)
0846 - Near-Infrared Vascular Imaging
0847 - Radiofrequency Ablation of the Renal Sympathetic Nerve for Hypertension
0848 - Ocriplasmin (Jetrea)
0849 - Teduglutide (Gattex)
0850 - Brachial Plexus Surgery
0851 - Palifermin (Kepivance)
0852 - Neurogenic Bladder: Selected Treatments
0853 - Wrist Arthroplasty
0854 - Electroretinography
0855 - Oprelvekin (Neumega)
0856 - Embolization: Selected Procedures
0857 - Elbow Arthroplasty
0858 - Organ Prolapse: Selected Procedures
0859 - Winged Scapular Surgery
0860 - Critical Flicker Fusion
0862 - Myopathy: Selected Tests
0863 - Peripheral Nerve Blocks
0864 - Erwinase (asparaginase Erwinia chrysanthemi)
0865 - Romidepsin (Istodax)
0866 - Rheumatic Diseases: Selected Tests
0867 - Clofarabine (Clolar)
0868 - Decitabine (Dacogen)
0869 - Ixabepilone (Ixempra)
0870 - Automated Audiometry
0871 - Stem Cell Transplant for Inherited Metabolic Disorders
0872 - Omacetaxine (Synribo)
0873 - Temsirolimus (Torisel)
0874 - Xofigo (Radium-223)

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