Noncovered Services/Items

Laparoscopic/ Percutaneous Ablation In Combination with Imaging Guidance as Treatment- Uterine Fibroids

Activity Therapy

Adrenal-to-Brain Transplantation with Autograft or Fetal Allograft

Automated External Defibrillators (AEDs)- Home Use

Allograft Facet Implants

Composite Tissue Allotransplantation Hand & Face

Altered Auditory Feedback (AAF)

Antiprothrombin Antibody Testing

Annulus Closure Devices for Annular Repair

High-resolution Anoscopy

Artificial

Retina

Artificial Anal Sphincter

Athletic Pubalgia Surgery

Transcatheter Arterial Chemo-embolization & Transcatheter Arterial Embolization

Auricular Electrostimu-

lation

Autologous/ Allogeneic  Hematopoietic Stem Cell Transplantation

AxiaLIF

Biomagnetic Therapy

Bronchial Thermoplasty

Canaloplasty

Cancer

Vaccines

Carotid Sinus Baroreflex Activation Device

Car-Ride Simulators for Infantile Colic

Cerebral Perfusion-Computed Tomography

Cervical & Thoracic Discography

Coblation Technology

Cold

Therapy

Combined PET/MRI

Electron Beam Computed Tomography (EBCT), Helical CT/Multi-slice Spiral CT (MSCT), for Detection of Coronary Arttery Calcium

Computer-assisted Musculo-skeletal Surgical Navigation

Contact Dissolution for Gallstones

Convection-enhanced Delivery of Therapeutic Agents to Brain

Active/Passive Cooling Devices & Active/Passive Devices Combining Cooling & Heatings

Cytological Examination & Fiberoptic Ductoscopy for Breast Cancer Screening

Cosmetic Surgery

Critical Flicker Fusion

Crit-Line

In-Line Monitor

Cryoablation  for Plantar Fasciitis or Plantar Fibroma

CT Scanning for Whole Body Imaging for General Sccreening

Dendritic Cell Immunotherapy

Doppler-guided Transanal Hemorrhoidal Dearteriali-zation

Dynamic Spinal Visualization

Electrothermal Arthroscopy

Electrothermal Intradiscal Therapies

Electrothermal Shrinkage

Electrical Stimulation: Dysphagia

Electrical Stimulation as Treatment for Pain

Electrical Stimulation for Xerostomia

Embolization Ovarian Vein & Internal Iliac Veins

Endobronchial Valve Devices

Endoluminal Gastric

Plication

Endoscopic Myotomy

Endoscopic Submucosal Injection of Bulking Agents

Endoscopic Treatment of GERD

Epiduroscopy, Epidural Spinal Endoscopy, Epidural Myeloscopy

Extracorporeal Carbon Dioxide Removal

Extracorporeal Pulse Activation Therapy (EPAT)

Extracorporeal Shock Wave Therapy (ESWT)

Transanal Radiofrequency Therapy- Treatment of Fecal Incontinence

Fetal Mesencephalic Transplantation

3-D/4-D Fetal Ultrasound

Transplantation with Fetal Xenografts

Functional Electrical Stimulation (FES)

Partial-hand Myoelectric Prosthesis

Hand Transplantation

Surgical Treatment for Chronic Headaches

Semi-implantable & Fully Implantable Middle Ear Hearing Aids

Left Atrial Hemodynamic Monitoring

Hippotherapy

H-Wave Electrical Stimulation for Pain Reduction

Insulin Potentiation Therapy (IPT)

immunoglobulin Treatment to Prevent Recurrent Spontaneous Abortion

Infrared Heating

Pad Systems

Interferential Therapy (IF)

Interspinous

Process Fixation Devices

Interstitial Laser Therapy

Intervertebral Stabilization Devices

Intradiscal Biacuplasty (IDB)

Intradiscal Electrothermal Therapy (IDET)

Intraocular Epiretinal Brachytherapy

Intrapulmonary Percussive Ventilation System

Irreversible Electroporation (IRE)

Bicompart-

mental Knee

Arthroplasty

Knee Ligament Arthrometer Testing

Laser Neurolysis

Laser Photocoagulation of Drusen

Leadless Pacemaker

Presbyopia-correcting Intraocular Lenses/ Astigmatism-correcting Intraocular Lenses

Low Level Laser Therapy (Cold Laser Therapy), High Power Laser Therapy

Lower Esophageal Sphincter Augmentation Devices

Axial or Presacral Lumbar Interbody Fusion

Macular/Foveal Translocation

 Magnetic Resonance Neurography

Magnetization-prepared Rapid Acquisition Gradient Echo Magnetic Resonance Imaging (MPRAGE MRI)

Mechanized Spinal Distraction Therapy

Mesenchymal Stem Cell Therapy

Metatarso-phalangeal Synthetic Cartilage Implant

Microcurrent Electrical Nerve Stimulation (MENS)

Microvascular Therapy in the Treatment of Peripheral Neuropathies

 Microwave

Tumor Ablation

MRI Bone Marrow

MRI to Screen, Diagnose, Monitor Disease Activity for Rheumatoid Arthritis/ Rheumatologic Conditions

Low-field MRI for Orthopaedic Applications

Positional

MRI

Myocardial Sympathetic Innervation Imaging with 123 Iodine Meta-iodobenzylgu-

anidine (MIBG)

Naltrexone Implants (or pellets) for Alcohol  & Opioid Dependence

Nasal Surgery for Snoring or Obstructive Sleep Apnea

 Nasal Valve Suspension

Near-infrared Coronary Imaging

Near-infrared Intravascular Ultrasound Coronary Imaging

Nerve Grafting- Radical Prostatectomy

Percutaneous Neuromodu-

lation Therapy

Neutron Beam Radiotherapy

Supraorbital Transcutaneous Neurostimulation

Outpatient Wireless Pulmonary Artery Pressure Monitoring for Heart Failure

Occipital Nerve Block Therapy

Occipital Nerve Stimulation

Surgical & Ablative Treatments of Occipital Neuralgia

Laser Treatment Onychomycosis

Opioid Antagonists under Sedation/ Anesthesia, For Opioid Detoxification

Intravascular Optical Coherence Tomography (OCT) for Coronary Disease

Paranasal Sinus Ultrasound

Partial Left Ventricul-ectomy (PLV)

Percutaneous Intradiscal Radiofrequency Thermocoagu- lation (PIRFT)

Percutaneous Ultrasonic Ablation of Soft Tissue

Percutaneous Ultrasonic Ablation of Soft Tissue

Surgical Decompression for Peripheral Polyneuropathy

Perirectal Spacers During Prostate Radiotherapy

PET Scanning with Gamma Camera

Photo-

coagulation Macular Drusen

Powered, Robotic Lower Body Exoskeleton

Prefabricated Oral Appliances to Treat Obstructive

Sleep Apnea

Transrectal Ultrasound-Guided Prostate Saturation Biopsy

Pulsed

Electrical Stimulation

Pulsed Radiofrequency

Radiofrequency Treatment for Urinary Incontinence

Radiofrequency Lesioning for Plantar Fasciitis

Radiofrequency Ablation Renal Sympathetic Nerves

Radiofrequency Spectroscopy/ Optical Coherence Tomography for iIntraoperative Assessment Surgical Margins for Breast-Conserving Surgery

Radiofrequency (RF) & Pulsed Radiofrequency (PRF) treatment Trigger Points

Radiostereo-

metric Analysis (RSA)

RenalVysion

Artificial Retinal

Devices

Internal Rib Fixation System

Devices for Maintaining Sinus Ostial Patency - PostOp

Percutaneous/ Endoscopic Spinal Surgery

Spectral Analysis of Prostate Tissue by Fluorescence Spectroscopy

Implanted

devices for Treatment of Spinal Stenosis

Self-operated Spinal Unloading Devices

Standing

Frames

Static Progressive Stretch (SPS) & Patient-actuated Serial Stretch (PASS) Devices

Stem Cell Therapy for  Peripheral Vascular Disease (PVD)

Stereo-lithography

Subtalar Arthroereisis

Extraosseous Subtalar Joint Implantation

Suprachoroidal Injection

Sympathetic Therapy

Tinnitus

Masking

Thermal Intradiscal Procedures

Focused Microwave Thermotherapy

Transmyocardial/Perventricular Device Closure of Ventricular Septal Defects

Threshold Electrical Stimulation (TES)

Transendo-

scopic Gastroplasty

Transcutaneous Electrical Joint Stimulation Devices (TEJSD)

Transoral incisionless Fundoplication

Transesophageal Radiofrequency Therapy

TruFUSE Facet Fusion for Minor Spinal

Transtympanic Micropressure Applications

Tumor

Treatment Field Therapy (TTFT)

Ultrasound Therapy for Wound Healing

Unicondylar Interpositional Spacer

Myoelectric Upper Extremity Orthotic

Uterine Nerve Ablation (UNA) & Presacral Neurectomy (PSN)

Vacuum Erection Devices (VED)

Vagal Nerve Stimulation(VNS) for Intractable  Depression

Vectra DA

Multi-biomarker Disease Activity (MBDA) Test

Vein Embolization:

Ovarian Vein/ Internal Iliac

Vertebral Body Stapling

Vertebral Decompression Therapy

Visco-canalostomy

Viscosupple-mentation of Shoulder

Vita Risk™ Molecular Assay for Age-Related Macular Degeneration (AMD)