Document Library

• Provider Medical Policy Spring 2023

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• Air Ambulance, Non-Emergent 9632

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• Implanted Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea 9636

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  Implanted Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea (OSA) MP9636
   
• Myoelectric Upper Limb Prosthetic and Orthotics 9637

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  Myoelectric Upper Limb Prosthetic and Orthotics Procedures 9637
• Microprocessor Controlled Knee Prostheses, With or Without Polycentric 9638

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  Microprocessor Controlled Knee Prostheses, With or Without Polycentric, Three-Dimensional Endoskeleton Hip Joint System MP9638
   
• Intraoperative Neurophysiological Monitoring (IONM) 9577

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• Mechanized Spinal Decompression Table for Low Back Pain 9644

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• Powered Robotic Lower-Limb Exoskeleton Device 9645

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• Skin and Soft Tissue-Engineered Substitutes for Wound and Surgical Care 9655

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• Home Use of Bilevel Positive Airway Pressure (BiPAP) for Conditions Other Than Obstructive Sleep Apnea (OSA) 9658

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