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Medicine Section

Policy Name	Date Modified
Actigraphy	06/01/2009
Anterior Eye Segment Optical Imaging	11/01/2008
Autologous Blood-Derived Growth Factors as a Treatment for Wound Healing and Other Miscellaneous Conditions	05/01/2009
Autologous Progenitor Cell Therapy for the Treatment of Damaged Myocardium due to Ischemia	02/01/2009
Automated Point-of-Care Nerve Conduction Studies	08/01/2008
Breast Duct Endoscopy (Ductoscopy)	10/01/2008
Charged Particle (Proton or Helium Ion) Radiation Therapy	06/09/2008
Correlated Audioelectric Cardiography	03/01/2009
Cutaneous Electrogastrography	09/01/2009
Electrical Impedance Scanning of the Breast	08/01/2009
Enhanced External Counterpulsation (EECP) for Chronic Stable Angina and Chronic Heart Failure	10/01/2009
Epiretinal Radiation Therapy for Age-Related Macular Degeneration	11/01/2008
Epithelial Cell Cytology in Breast Cancer Risk Assessment and High Risk Patient Management (Ductal Lavage and Suction Collection Systems)	01/01/2009
Extracorporeal Photopheresis as a Treatment of Graft-versus-Host Disease, Autoimmune Disease, and Cutaneous T-Cell Lymphoma	04/01/2009
Extracorporeal Shock Wave Therapy in the Treatment of Peyronie's Disease	08/01/2008
Extracorporeal Shock Wave Treatment for Plantar Fasciitis and Other Musculoskeletal Conditions	03/01/2009
Gait Analysis	10/01/2008
Gene Therapy	07/01/2008
Hyperbaric Oxygen Pressurization	11/01/2008
In Vivo Analysis of Colorectal Polyps	02/01/2009
Low Density Lipid Apheresis	11/01/2009
Low Level Laser Treatment of Neuromuscular Pain Disorders and Other Miscellaneous Conditions	08/01/2009
Measurement of Exhaled Nitric Oxide and Exhaled Breath Condensates in the Diagnosis and Management of Patients with Asthma and Other Respiratory Diagnoses	09/01/2008
Microwave Thermotherapy for Primary Breast Cancer	08/01/2009
Monitoring of Regional Cerebral Blood Flow Using an Implanted Cerebral Thermal Perfusion Probe	06/16/2008
Neurofeedback	11/01/2008
Noncontact Radiant Heat Bandage for the Treatment of Wounds	03/01/2009
Non-Contact Ultrasound Treatments for Wounds	11/01/2009
Non-Invasive Measurement of Left Ventricular End Diastolic Pressure (LVEDP) in the Outpatient Setting	04/01/2009
Noninvasive Measurements of Cardiac Hemodynamics in the Outpatient Setting	09/01/2008
Paraspinal Surface Electromyography (EMG) to Evaluate and Monitor Back Pain	09/01/2008
Photopheresis for the Treatment of Solid Organ Transplant Rejection	10/01/2008
Prolotherapy	12/01/2008
Quantitative Sensory Testing	01/01/2009
Research Urgent Treatments	06/09/2009
Rhinomanometry and Acoustic and Optical Rhinometry	08/01/2008
Signal-Averaged Electrocardiography (SAECG)	09/01/2009
Spinal Manipulation Under Anesthesia	05/01/2009
Subconjunctival Retinal Prosthesis	01/01/2009
Sublingual Immunotherapy as a Technique of Allergen Specific Therapy	11/01/2008
Suprachoroidal Delivery of Pharmacologic Agents	11/01/2008
Temporary Prostatic Stent	05/01/2009
T-Wave Alternans	05/01/2009
Vertebral Axial Decompression	12/01/2008


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