https://www.premera.com/medicalpolicies/8.03.505.pdf#search=policy
MEDICAL POLICY - 8.03.505 Speech Therapy Effective Date: June 1, 2024 Last Revised: May ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/10.01.514.pdf#search=policy
MEDICAL POLICY - 10.01.514 Cosmetic and Reconstructive Services Effective Date: May 1, ... POLICY CRITERIA | CODING | RELATED INFORMATION CONSENSUS REVIEW | REFERENCES | HISTORY ∞ ...
https://www.premera.com/medicalpolicies/5.01.535.pdf#search=policy
MEDICAL POLICY - 5.01.535 Erythropoiesis-Stimulating Agents BCBSA Ref. Policy: 5.01.04 Effective Date: July 1, 2024 Last Revised: June 24, 2024 Replaces: 5.01.04 RELATED MEDICAL ...
https://www.premera.com/medicalpolicies/7.01.125.pdf#search=policy
MEDICAL POLICY - 7.01.125 Occipital Nerve Stimulation BCBSA Ref. Policy: 7.01.125 Effective Date: July 1, 2024 Last Revised: June 10, 2024 Replaces: N/A RELATED MEDICAL POLICIES: ...
https://www.premera.com/medicalpolicies/7.01.128.pdf#search=policy
MEDICAL POLICY - 7.01.128 Bronchial Valves BCBSA Ref. Policy: 7.01.128 Effective Date: Sept. 1, 2023 Last Revised: Aug. 7, 2023 Replaces: N/A RELATED MEDICAL POLICIES: None Select ...
https://www.premera.com/medicalpolicies/7.01.132.pdf#search=policy
MEDICAL POLICY - 7.01.132 Transcatheter Aortic-Valve Implantation for Aortic Stenosis BCBSA Ref. Policy: 7.01.132 Effective Date: May 1, 2024 Last Revised: April 9, 2024 Replaces: ...
https://www.premera.com/medicalpolicies/7.01.133.pdf#search=policy
MEDICAL POLICY - 7.01.133 Microwave Tumor Ablation BCBSA Ref. Policy: 7.01.133 Effective Date: Jan. 1, 2024 Last Revised: Dec. 11, 2023 Replaces: N/A RELATED MEDICAL POLICIES: ...
https://www.premera.com/medicalpolicies/7.01.519.pdf#search=policy
MEDICAL POLICY - 7.01.519 Treatment of Varicose Veins/Venous Insufficiency BCBSA Ref. Policy: 7.01.124 Effective Date: June 1, 2024 Last Revised: May 14, 2024 Replaces: 7.01.55, ...
https://www.premera.com/medicalpolicies/7.01.549.pdf#search=policy
MEDICAL POLICY - 7.01.549 Knee Arthroscopy in Adults Effective Date: Nov. 1, 2023 Last ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/7.01.555.pdf#search=policy
MEDICAL POLICY - 7.01.555 Facet Joint Denervation BCBSA Ref. Policy: 7.01.116 Effective Date: Feb. 1, 2024 Last Revised: Jan. 22, 2024 Replaces: 7.01.116 RELATED MEDICAL POLICIES: ...
https://www.premera.com/medicalpolicies/2.01.533.pdf#search=policy
MEDICAL POLICY - 2.01.533 Upper Gastrointestinal (UGI) Endoscopy for Adults Effective ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/5.01.521.pdf#search=policy
POLICY - 5.01.521 Pharmacologic Treatment of Neuropathy, Fibromyalgia, and Seizure Disorders Effective Date: April 1, 2024* Last Revised: Mar. 12, 2024 Replaces: N/A *This policy ...
https://www.premera.com/medicalpolicies/7.01.591.pdf#search=policy
MEDICAL POLICY - 7.01.591 Interspinous Fixation (Fusion) Devices BCBSA Ref. Policy: 7.01.138 Effective Date: July 1, 2024 Last Revised: June 11, 2024 Replaces: N/A RELATED MEDICAL ...
https://www.premera.com/medicalpolicies/7.01.107.pdf#search=policy
MEDICAL POLICY - 7.01.107 Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers) BCBSA Ref. Policy: 7.01.107 Effective Date: July 1, 2024 Last Revised: June 10, ...
https://www.premera.com/medicalpolicies/7.01.559.pdf#search=policy
MEDICAL POLICY - 7.01.559 Sinus Surgery in Adults BCBSA Ref. Policies: 7.01.105, 7.01.155 ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/7.01.562.pdf#search=policy
MEDICAL POLICY - 7.01.562 Intraoperative Neurophysiologic Monitoring BCBSA Ref. Policy: 7.01.58 Effective Date: July 1, 2024 Last Revised: June 11, 2024 Replaces: 7.01.58 RELATED ...
https://www.premera.com/medicalpolicies/8.01.28.pdf#search=policy
MEDICAL POLICY - 8.01.28 Hematopoietic Cell Transplantation for Central Nervous System Embryonal Tumors and Ependymoma BCBSA Ref. Policy: 8.01.28 Effective Date: April 1, 2024 ...
https://www.premera.com/medicalpolicies/8.01.538.pdf#search=policy
MEDICAL POLICY - 8.01.538 Allogeneic Hematopoietic Cell Transplantation for Genetic Diseases and Acquired Anemias BCBSA Ref. Policy: 8.01.22 Effective Date: Dec. 1, 2023 Last ...
https://www.premera.com/medicalpolicies/1.01.506.pdf#search=policy
MEDICAL POLICY - 1.01.506 Adjustable Cranial Orthoses for Positional Plagiocephaly and Craniosynostoses BCBSA Ref Policy: 1.01.11 Effective Date: June 1, 2024 Last Revised: May ...
https://www.premera.com/medicalpolicies/1.03.501.pdf#search=policy
MEDICAL POLICY - 1.03.501 Custom-made Knee Orthoses (Braces), Ankle-Foot- Orthoses, and ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...