https://www.premera.com/medicalpolicies/7.01.137.pdf#search=policy
MEDICAL POLICY - 7.01.137 Magnetic Esophageal Sphincter Augmentation to Treat Gastroesophageal Reflux Disease BCBSA Ref. Policy: 7.01.137 Effective Date: Feb. 1, 2023 Last ...
https://www.premera.com/medicalpolicies/7.01.142.pdf#search=policy
MEDICAL POLICY - 7.01.142 Surgery for Groin Pain in Athletes BCBSA Ref. Policy: 7.01.142 Effective Date: May 1, 2022 Last Revised: April 11, 2022 Replaces: N/A RELATED MEDICAL ...
https://www.premera.com/medicalpolicies/7.01.144.pdf#search=policy
MEDICAL POLICY - 7.01.144 Patient-Specific Cutting Guides for Joint Arthroplasty BCBSA Ref. Policy: 7.01.144 Effective Date: July 1, 2022 Last Revised: June 13, 2022 Replaces: N/A ...
https://www.premera.com/medicalpolicies/7.01.159.pdf#search=policy
MEDICAL POLICY - 7.01.159 Sphenopalatine Ganglion Block for Headache BCBSA Ref. Policy: 7.01.159 Effective Date: Feb. 1, 2023 Last Revised: Jan. 9, 2023 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/7.01.29.pdf#search=policy
MEDICAL POLICY - 7.01.29 Percutaneous Electrical Nerve Stimulation and Percutaneous Neuromodulation Therapy BCBSA Ref. Policy: 7.01.29 Effective Date: Aug. 1, 2022 Last Revised: ...
https://www.premera.com/medicalpolicies/7.01.551.pdf#search=policy
MEDICAL POLICY - 7.01.551 Lumbar Spine Decompression Surgery: Discectomy, Foraminotomy, ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/7.01.567.pdf#search=policy
MEDICAL POLICY - 7.01.567 Surgical Treatments for Lymphedema and Lipedema BCBSA Ref. Policy: 7.01.162, 7.01.169, 7.01.173 Effective Date: Feb. 1, 2023 Last Revised: Jan. 9, 2023 ...
https://www.premera.com/medicalpolicies/7.01.573.pdf#search=policy
MEDICAL POLICY - 7.01.573 Hip Arthroplasty in Adults Effective Date: Aug. 1, 2022 Last ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/8.01.55.pdf#search=policy
MEDICAL POLICY - 8.01.55 Stem Cell Therapy for Peripheral Arterial Disease BCBSA Ref. Policy: 8.01.55 Effective Date: Apr. 1, 2022 Last Revised: Mar. 21, 2022 Replaces: N/A ...
https://www.premera.com/medicalpolicies/8.01.62.pdf#search=policy
MEDICAL POLICY - 8.01.62 Electronic Brachytherapy for Nonmelanoma Skin Cancer BCBSA Ref. Policy: 8.01.62 Effective Date: Sept. 1, 2022 Last Revised: Aug. 22, 2022 Replaces: N/A ...
https://www.premera.com/medicalpolicies/2.02.16.pdf#search=policy
MEDICAL POLICY - 2.02.16 Ultrasonographic Measurement of Carotid Intimal-Medial Thickness as an Assessment of Subclinical Atherosclerosis BCBSA Ref. Policy: 2.02.16 Effective Date: ...
https://www.premera.com/medicalpolicies/2.02.18.pdf#search=policy
MEDICAL POLICY - 2.02.18 Progenitor Cell Therapy for the Treatment of Damaged Myocardium Due to Ischemia BCBSA Ref. Policy: 2.02.18 Effective Date: Aug. 1 2022 Last Revised: July ...
https://www.premera.com/medicalpolicies/2.04.100.pdf#search=policy
MEDICAL POLICY - 2.04.100 Cardiovascular Risk Panels BCBSA Ref. Policy: 2.04.100 Effective Date: Feb. 1, 2023 Last Revised: Jan. 23, 2023 Replaces: 2.04.509 RELATED MEDICAL ...
https://www.premera.com/medicalpolicies/5.01.519.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.519 Increlex® (mecasermin); Recombinant Human ... POLICY CRITERIA | CODING | RELATED INFORMATION EVIDENCE REVIEW | REFERENCES | HISTORY ∞ ...
https://www.premera.com/medicalpolicies/5.01.558.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.558 Pharmacologic Treatment of High Cholesterol ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/5.01.562.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.562 Imlygic® (talimogene laherparepvec) Effective Date: ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/5.01.564.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.564 Pharmacotherapy of Miscellaneous Autoimmune Diseases ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/5.01.565.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.565 Pharmacotherapy of Multiple Sclerosis Effective ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/5.01.589.pdf#search=policy
PHARMACY POLICY - 5.01.589 BRAF and MEK Inhibitors Effective Date: Jan. 1, 2023 Last ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/5.01.590.pdf#search=policy
PHARMACY POLICY - 5.01.590 Bruton's Kinase Inhibitors Effective Date: Mar. 1, 2023 Last ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...