Chelation Therapy - Dimercaprol (BAL)
Chelation Therapy - Edetate Calcium Disodium (Calcium EDTA)
Chelation Therapy - Deferoxamine Mesylate (Desferal)
Peripheral Artery Disease of the Lower Extremities Angiography, Screening & Exercise Rehabilitation
-FloridaBlue-
-Humana-
Autologous & Allogeneic Pancreatic Islet Cell Transplantation
Hematopoietic Stem Cell Transplantation for Germ Cell Tumors
Hematopoietic Stem Cell Transplantation for Hodgkin Disease & non-Hodgkin Lymphoma
Donor Lymphocyte Infusion for Hematologic Malignancies after Allogeneic Hematopoietic Progenitor Cell Transplantation
Hematopoietic Stem Cell Transplantation for Genetic Diseases & Aplastic Anemias
Hematopoietic Stem Cell Transplantation for Multiple Myeloma & Other Plasma
Cell Dyscrasias
Hematopoietic Stem Cell Transplantation for Pediatric Solid Tumors
Hematopoietic Stem Cell Transplantation for Select Leukemias & Myelodysplastic Syndrome
Hematopoietic Stem Cell Transplantation for Thalassemia Major & Sickle Cell Disease
-Aetna-
Umbilical Cord Blood Progenitor Cell Collection, Storage & Transplantation
Autologous Cellular Therapy for Certain Indications
-UHC-
Autologous Skeletal Myoblast/Mononuclear Bone Marrow Cell Transplantation
-Aetna-
Assessing Your Weight
Healthy Weight & Finding a Balance
Losing Weight
Preventing Weight Gain
Chronic Kidney Disease
Chronic Kidney Disease Basic Education
Chronic Kidney Disease Prevention & Risk Management
Diabetes Care Schedule
Diabetes Education & Support
Diabetes
& Mental Health
Preventing Diabetic Complications & Managing Sick Days
Education & Diabetic Management During
Ramadan
Diabetic Pharmacological Management During Ramadan
Risk Stratification of Patients with T2 DM Who Wish to Fast During Ramadan
Structured Pre-Ramadan Education to Raise Awareness Risks of Diabetes & Fasting
Extended release opioids
Healthy Eating for a Healthy Weight
Healthy Weight
Healthy Weight & Finding a Balance
Physical Activity for a Healthy Weight
Tips for Parents-Ideas to Help Children Maintain a Healthy Weight
Healthy Weight & Eating Well with Diabetes
Living with Diabetes
Physical Activity for People with Diabetes
Preparing for Natural Disasters for People with Diabetes
Management of Your Blood Sugar
Managing Your Blood Sugar
Preventing Heart Disease
Preventing Heart Disease & Choosing Healthy Habits
Preventing Heart Disease & Knowing Your Risk for Heart Disease
Adult Preventive Health Guidelines
Quick Screen to Identify Excessive Drinking
Chronic
Vertigo Treatment
Dysphagia/Swallowing Diagnosis & Therapy
Ultrasonic
Surgery for Meniere's Syndrome
Voice
Therapy
-Humana-
Chelation Therapy - Edetate Calcium Disodium (Calcium EDTA)
Chelation Therapy - Deferoxamine Mesylate (Desferal)
Chelation Therapy - Dimercaprl (BAL)
Gastric Pacing, Enterra Therapy
Levator Syndrome Treatment
Out-of-Network Outpatient Dialysis at In-Network Level of Benefits
Percutaneous Tibial Nerve Stimulation
Peritoneal Dialysis
Sacral
Nerve Stimulation
Allogenic Hematopoietic Cell Transplants for Sickle Cell Anemia & beta-Thalassemia
Chelation Therapy - Edetate Calcium Disodium (Calcium EDTA)
Chelation Therapy - Deferoxamine Mesylate (Desferal)
Chelation Therapy - Dimercaprol (BAL)
Low Density Lipoprotein (LDL) Apheresis
Therapeutic Phlebotomy
Acute Inpatient Rehabilitation
Axial/Spinal Decompression Therapy/Mechanical Traction (Provided in a Clinic Setting)
-Cigna-
Physical Therapy & Occupational Therapy
Therapy & Rehabilitation Services
Range of Motion Testing
Strapping
Treatment of Autism Spectrum Disorders
-FloridaBlue-
Unna
Boot
Electrical Stimulation for the Treatment of Arthritis
Suit Therapy
-Aetna-
Warming Therapy & Ultrasound Therapy for Wounds
-UHC-
Ketogenic Diet for Treatment of Intractable Seizures
-Aetna-
Monoclonal Antibody Therapies for Migraine Prevention
Neurological & Brain Injury Life Skills & Rehabilitation
Speech Language Pathology (SLP) Services: Communication Disorders
Subacute Inpatient Rehabilitation
Spinal Cord Injury Inpatient Rehabilitation
Attention Deficit Hyperactivity Disorder Assessment & Treatment
Screening for Autism Spectrum Disorders & Rett Syndrome
Behavioral Health Observation Treatment Pathway
-Aetna-
-UHC-
Group Psychotherapy
Health & Behavior Assessment Intervention
Inpatient Adult Psychiatry-
Treatment Days 1-6
Inpatient Adult Psychiatry-
Treatment Days 7-13
Inpatient Treatment for Substance-Related & Addictive Disorder Treatment
Inpatient Withdrawal Management (Detoxification)
Intensive Outpatient Program Substance-Related & Addictive Disorder Treatment
Interactive Complexity Services
Low Intensity Residential Clinical Services for Substance-Related & Addictive Disorder Treatment
Adult Major Depressive Disorder (MDD): Suicide Risk Assessment (CMS161v10)
Methadone Treatment for Opiate Addiction
Observation Status Adult Psychiatry
Outpatient (Office Based) Medication Assisted Treatment (MAT) Opioid Use Disorder
Outpatient Treatment of Substance-Related & Addictive
Disorder Treatment
Partial Hospitalization Program Substance-Related & Addictive
Disorder Treatment
Partial Hospitalization Program: Adult Psychiatry
Partial Hospitalization Program: Psychiatric Care
Psychiatric Diagnostic Evaluation
Psychiatric Inpatient Hospitalization
Psychoanalysis
Psychological & Neuropsycho-logical Tests
Psychosocial Rehabilitation Services
Psychotherapy
Psychotherapy for Crisis
Residential Treatment Center for Substance-Related Addictive Disorder Treatment
Residential Treatment Center with 24-Hour Nursing for Substance-Related & Addictive
Disorder Treatment
Residential Withdrawal Management (Detoxification)
Substance-Related & Addictive
Disorder Treatment
Substance-Related & Addictive
Disorder Treatment - Detoxification
Substance-Related & Addictive
Disorder Treatment - Rehabilitation
Substance-Related Outpatient Withdrawal (Detoxification) with Extended On-Site Monitoring
Substance-Related Outpatient Withdrawal (Detoxification) without Extended On-Site Monitoring
Diagnostic
Aerosol or Vapor Inhalation
Electrical Stimulators - Diaphragmatic/Phrenic Nerve, Functional and Neuromuscular
Noninvasive Home Ventilator Therapy for Respiratory Failure
Obstructive
Sleep Apnea Treatment
Pulmonary Rehabilitation
Respiratory Therapeutic Services
Accelerated Partial Breast Irradiation
(APBI)
Accelerated Breast Irradiation & Brachytherapy Boost After Breast-Conserving Surgery for Early-Stage Breast Cancer
Charged-Particle (Proton or Helium Ion) Radiotherapy for Neoplastic Conditions
Cranial Stereotactic Radiosurgery (SRS) & Cranial Stereotactic Radiotherapy (SRT)
Electric Tumor Treatment
Field Therapy
Endobronchial Brachytherapy
High-Dose Rate Temporary Prostate Brachytherapy
Hyperthermia (deep, intracavitary, whole body) for Cancer Therapy
Hyperthermia (superficial external, interstitial) for Cancer Therapy
-UHC-
Image-Guided Radiation Therapy
-FloridaBlue-
Implantable Beta-Emitting Microspheres for Treatment of Malignant Tumors
Inpatient Admission for Radiation Therapy for Cervical or Thyroid Cancer
Intensity-Modulated Radiation Therapy (IMRT): Abdomen & Pelvis
-UHC-
Intensity-Modulated Radiotherapy of the Breast & Lung
Intensity-Modulated Radiotherapy: Cancer of the Head & Neck or Thyroid
Intensity-Modulated Radiotherapy of the Prostate
Intraoperative Radiation
Therapy
Microwave Thermotherapy
Isolated Limb Perfusion/Infusion for Malignant Melanoma
Proton Beam Radiotherapy ( Non CNS )
Radiation Therapy for T1 Basal Cell & Squamous Cell Carcinomas of the Skin
Radiation Therapy: Fractionation, Image-Guidance, & Special Services
Radioembol-ization for Primary & Metastatic Tumors of the Liver
-UHC-
Selective Internal Radiation Therapy (SIRT) for Primary & Secondary Hepatic Malignancy (Yttrium-90 -Microsphere Hepatic Brachytherapy)
Whole Brain Radiotherapy (WBRT)
-United-
-FloridaBlue-
Actinic
Keratosis
Allergen Immunotherapy
Allergy
Testing
Eye
Allergy Testing: Patch Testing
Allergy Testing In Vivo (Skin Tests)
Electrical Stimulation (ES) & Electromagn-etic Therapy for the Treatment of Wounds
-Humana-
Topical Photosensitizers used with PDT for Actinic Keratoses
& Certain Skin Cancers
EpiFix Wound Treatment
Lymphedema & Venous Stasis Ulcer Treatments
Targeted Phototherapy & Psoralen with Ultraviolet A for Vitiligo
Complex Lymphedema Therapy (Complete Decongestive Therapy)
-Cigna-
Allergy Immunotherapy
Ambulance Services-
Air & Water
Ambulance Services-
Non-emergency Ground
Ancillary Services for Pregnancy Complications
Art Therapy
-Humana-
Brachytherapy
Cold Therapy Devices/Heating Devices/Combined Heat & Cold Therapy Devices
Donor Human Milk
Electric Stimulation for Pain, Swelling & Function in a Clinic Setting
Equine-assisted Therapy for Behavioral Health
-Anthem-
Eye Movement Desensitization &
Reprocessing (EMDR)
Home Phototherapy Devices for Neonatal Hyperbilirubi-nemia
Hydration Therapy
Iontophoresis
Inpatient Subacute Care
-Anthem-
-Cigna-
-Humana-
-Medicare-
Low Level Laser Therapy (Cold Laser Therapy), High Power Laser Therapy
Manipulative Therapy
Medical
Maggots
Medicinal Leech Therapy
Neonatal Level of Care
-FloridaBlue-
-Humana-
Non-pharmacologic Treatments for Chronic
Vertigo
Outpatient Skilled Nursing & Skilled Rehabilitation Services
Observation Room Services
Observation vs. Admission Criteria Making for the Treatment of Emergency Room Conditions
Outpatient Use of Arixtra, Direct Thrombin Inhibitors, and Low Molecular Weight Heparin (LMWH)
Parenteral Drug Administration & In-Office Dispensing of Medications
Pet
Therapy
Pritikin Program
Private Duty Nursing in the Home Setting
Skilled Nursing Facility Services
Special Treatment Procedure & Special Physics Consult
Transcatheter Infusion
Therapy
-FloridaBlue
Adoptive Immunotherapy
-Cigna-
-FloridaBlue-
Auditory & Sensory Integration Training Therapy (AIT)
Autologous Cell-Based Therapy for Cardiac and Peripheral Arterial Disease
Autologous Platelet-Derived Growth Factors (Platelet-Rich Plasma [PRP])
Biomagnetic Therapy
-Anthem-
Bronchial Thermoplasty
-Cigna-
-FloridaBlue-
Carotid Intima-Media Thickness Measurement
-Cigna-
-Cigna-
-FloridaBlue-
-Cigna-
Custodial & Non-Skilled Services
-Cigna-
Exhaled Nitric Oxide & Exhaled Breath Condensate in the Management of Respiratory
Disorders
Headache & Occipital Neuralgia Treatment
-Cigna-
High-Frequency Pulsed Electro-magnetic Stimulation
-Aetna-
Hippotherapy
-Aetna-
Low Level Laser Therapy (Cold Laser Therapy), High Power Laser Therapy
-Cigna-
Neutron Beam Radiotherapy
-Anthem-
-Cigna-
Rehabilitative Devices with Remote Monitoring
Ultrasound Therapy for Wound Healing
Virtual Reality-Assisted Therapy Systems
-Anthem-
-Humana-
-Anthem-
™
Copyright 2006-2023 Automated Clinical Guidelines, LLC. All rights reserved.
™
Home Contact FAQ
Account