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May 2018 Medical Policy Updates:
- MP033 Varicose Vein Therapy – REVISED – (Added Indication; Removed Exclusion)
- MP165 Treatment of Vestibular Disorders REVISED – (Added Exclusion)
- MP233 Injectable Blood Products for Orthopedic Conditions – REVISED – (Modified Title; Added Exclusion)
- MP217 Polysomnography and Sleep Studies – REVISED – (Removed Exclusion)
- MP265 Proteomic Serum Analysis – REVISED – (clarified Medicare Business Segment)
- MP273 Gene-based Testing and/or Protein Biomarkers for Diagnosis and Management of Prostate Cancer – REVISED – (Title change)
The following policies have been reviewed with no change to the policy section. Additional references or background information was added to support the current policy:
- MP037 Home Phlebotomy Program
- MP039 Home Uterine Monitoring
- MP044 Aquatic Therapy
- MP046 Progressive Stretch Devices
- MP062 TMLR
- MP076 HH/DME Hyperbilirubinemia
- MP081 Chelation Therapy
- MP097 Genetic Testing for BRCA
- MP127 Prolotherapy
- MP133 Meniscal Allograft
- MP198 Pulse Oximetry for Pediatric Home Use
- MP212 Non-Contact low-frequency Ultrasound Management (MIST Therapy)
- MP263 Minimally Invasive Lumbar Decompression (MILD)
- MP293 Intrathecal Infusion Pump
- MP315 Esophageal Sphincter Augmentation
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