https://www.premera.com/medicalpolicies/8.03.502.pdf#search=policy
MEDICAL POLICY - 8.03.502 Physical Medicine and Rehabilitation - Physical Therapy and ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/1.01.18.pdf#search=policy
MEDICAL POLICY - 1.01.18 Pneumatic Compression Pumps for Treatment of Lymphedema and Venous Ulcers BCBSA Ref. Policy: 1.01.18 Effective Date: June 1, 2024 Last Revised: May 13, ...
https://www.premera.com/medicalpolicies/2.01.16.pdf#search=policy
MEDICAL POLICY - 2.01.16 Recombinant and Autologous Platelet-Derived Growth Factors for Wound Healing and Other Non-Orthopedic Conditions BCBSA Ref. Policy: 2.01.16 Effective Date: ...
https://www.premera.com/medicalpolicies/2.03.07.pdf#search=policy
MEDICAL POLICY - 2.03.07 Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Select Intra-Abdominal and Pelvic Malignancies BCBSA Ref. Policy: 2.03.07 Effective Date: Oct. 1, ...
https://www.premera.com/medicalpolicies/2.04.73.pdf#search=policy
MEDICAL POLICY - 2.04.73 Intracellular Micronutrient Analysis BCBSA Ref. Policy: 2.04.73 Effective Date: Mar. 1, 2024 Last Revised: Feb. 12, 2024 Replaces: N/A RELATED MEDICAL ...
https://www.premera.com/medicalpolicies/5.01.518.pdf#search=policy
PHARMACY POLICY - 5.01.518 BCR-ABL Kinase Inhibitors Effective Date: May 1, 2024 Last ... POLICY CRITERIA | CODING | RELATED INFORMATION EVIDENCE REVIEW | REFERENCES | HISTORY ∞ ...
https://www.premera.com/medicalpolicies/5.01.529.pdf#search=policy
PHARMACY POLICY - 5.01.529 Management of Opioid Therapy Effective Date: May 1, 2024 Last ... below to be directed to that section. POLICY CRITERIA | CODING | RELATED INFORMATION ...
https://www.premera.com/medicalpolicies/6.01.521.pdf#search=policy
MEDICAL POLICY - 6.01.521 Bone Mineral Density Studies BCBSA Ref Policy: 6.01.01 Effective Date: Dec. 1, 2023 Last Revised: Nov. 6, 2023 Replaces: N/A RELATED MEDICAL POLICIES: ...
https://www.premera.com/medicalpolicies/7.01.131.pdf#search=policy
MEDICAL POLICY - 7.01.131 Transcatheter Pulmonary Valve Implantation BCBSA Ref. Policy: 7.01.131 Effective Date: Sept. 1, 2023 Last Revised: Aug. 7, 2023 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/7.01.139.pdf#search=policy
MEDICAL POLICY - 7.01.139 Peripheral Subcutaneous Field Stimulation BCBSA Ref. Policy: 7.01.139 Effective Date: July 1, 2024 Last Revised: June 10, 2024 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/7.01.546.pdf#search=policy
MEDICAL POLICY - 7.01.546 Spinal Cord and Dorsal Root Ganglion Stimulation BCBSA Ref. Policy: 7.01.25 Effective Date: July 1, 2024 Last Revised June 24, 2024 Replaces: 7.01.25 ...
https://www.premera.com/medicalpolicies/7.01.547.pdf#search=policy
MEDICAL POLICY - 7.01.547 Implantable Bone-Conduction and Bone-Anchored Hearing Aids BCBSA Ref. Policy: 7.01.03 Effective Date: May 1, 2024 Last Revised: April 8, 2024 Replaces: ...
https://www.premera.com/medicalpolicies/7.01.558.pdf#search=policy
MEDICAL POLICY - 7.01.558 Rhinoplasty and Other Nasal Procedures Effective Date: June 1, ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/7.01.72.pdf#search=policy
POLICY - 7.01.72 Percutaneous Intradiscal Electrothermal Annuloplasty, Radiofrequency Annuloplasty, Biacuplasty, and Intraosseous Basivertebral Nerve Ablation BCBSA Ref. Policy: ...
https://www.premera.com/medicalpolicies/7.03.09.pdf#search=policy
MEDICAL POLICY - 7.03.09 Heart Transplant BCBSA Ref. Policy: 7.03.09 Effective Date: Nov. 1, 2023 Last Revised: Oct. 9, 2023 Replaces: Extracted from 7.03.509 RELATED MEDICAL ...
https://www.premera.com/medicalpolicies/8.01.529.pdf#search=policy
MEDICAL POLICY - 8.01.529 Hematopoietic Cell Transplantation for Non-Hodgkin Lymphomas BCBSA Ref. Policy: 8.01.20 Effective Date: May 1, 2024 Last Revised: April 8, 2024 Replaces: ...
https://www.premera.com/medicalpolicies/8.01.540.pdf#search=policy
MEDICAL POLICY - 8.01.540 Cranial Electrotherapy Stimulation and Auricular Electrostimulation BCBSA Ref. Policy: 8.01.58 Effective Date: May 1, 2024 Last Revised: April 9, 2024 ...
https://www.premera.com/medicalpolicies/9.02.501.pdf#search=policy
MEDICAL POLICY - 9.02.501 Orthognathic Surgery Effective Date: Jan. 1, 2024 Last Revised: ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/13.01.500.pdf#search=policy
MEDICAL POLICY - 13.01.500 Prescription Digital Therapeutics BCBSA Ref. Policy: 3.03.02 Effective Date: June 1, 2024 Last Revised: May 14, 2024 Replaces: N/A RELATED MEDICAL ...
https://www.premera.com/medicalpolicies/2.01.535.pdf#search=policy
MEDICAL POLICY - 2.01.535 Temporomandibular Joint Disorder BCBSA Ref. Policy: 2.01.21, 5.01.05 Effective Date: May 1, 2024 Last Revised: April 8, 2024 Replaces: 2.01.21 RELATED ...