Surgery Table of Contents

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Surgery Section

Policy Name	Date Modified
Artificial Intervertebral Disc	12/01/2009
Autologous Chondrocyte Implantation	05/01/2009
Balloon Catheter Dilation for Treatment of Chronic Sinusitis	03/01/2010
Cochlear Implant	01/01/2010
Computer Assisted Navigation for Orthopedic Procedures of the Pelvis and Appendicular Skeleton	06/01/2009
Conjunctival Incision with Posterior Juxtascleral Placement of Anecortave Acetate Depot Suspension	12/01/2009
Cosmetic and Reconstructive Surgery	01/01/2010
Cryosurgical Ablation of Miscellaneous Solid Tumors	01/01/2010
Decompression of Intervertebral Discs Using Laser (Laser Discectomy) or Radiofrequency (DISC Nucleoplasty™)	06/01/2009
Deep Brain Stimulation for Movement Disorders and Miscellaneous Conditions	10/01/2008
Emerging Surgical Treatments for Glaucoma	05/01/2009
Endovascular Grafts for Abdominal Aortic Aneurysms	01/01/2009
Endovascular Stent Grafts for Thoracic Aortic Aneurysms or Dissections	01/01/2009
Extracranial Carotid Angioplasty/Stenting	01/01/2010
Facet Joint Injections	01/01/2010
Femoroacetabular Impingement (FAI) Surgery	08/11/2009
Gastric Electrical Stimulation	01/01/2010
Implantable Bone Conduction Hearing Aids	01/01/2010
Implantation of Intrastromal Corneal Ring Segments	01/01/2010
Interspinous Distraction Devices (Spacers)	01/01/2009
Keratoprosthesis	10/01/2008
Lumbar Dynamic Stabilization	01/01/2009
Lumbar Spine Surgery	05/12/2009
Lysis of Epidural Adhesions	01/01/2010
Mechanical Embolectomy for Treatment of Acute Stroke	11/01/2009
Meniscal Allograft Transplantation	04/01/2009
MRI-Guided Focused Ultrasound (MRgFUS) for the Treatment of Uterine Fibroids and Other Tumors	05/01/2009
Nerve Graft in Association with Radical Prostatectomy	11/01/2009
Orthognathic Surgery	03/01/2010
Ovarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome	11/01/2009
Percutaneous Angioplasty and Stenting of Veins	02/09/2010
Percutaneous Axial Anterior Lumbar Fusion	01/01/2010
Percutaneous Discectomy	03/01/2009
Percutaneous Neuromodulation Therapy (PNT)	04/01/2009
Percutaneous Intradiscal Electrothermal Annuloplasty (IDET) and Percutaneous Intradiscal Radiofrequency Thermocoagulation	01/01/2010
Percutaneous Transluminal Angioplasty of Intracranial Atherosclerotic Stenosis With or Without Stenting	05/12/2009
Photocoagulation of Macular Drusen	12/01/2009
Phototherapeutic Keratectomy	06/16/2008
Posterior Tibial Nerve Stimulation for Voiding Dysfunction	01/01/2010
Pulsed Radiofrequency for Facet Joint Denervation	07/01/2009
Radiofrequency Ablation of Tumors (RFA)	01/01/2010
Radiofrequency Lesioning for the Treatment of Plantar Fasciitis	08/01/2008
Reconstructive Breast Surgery, Mastopexy, and Management of Breast Implants	05/01/2009
Reduction Mammaplasty	11/01/2009
Sacral Nerve Modulation/Stimulation for Pelvic Floor Dysfunction	01/01/2010
Shoulder Resurfacing	10/01/2009
Spinal Cord Stimulation for Treatment of Pain	03/10/2010
Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy	01/01/2010
Subtalar Arthroereisis	06/01/2009
Surgeries for Snoring, Obstructive Sleep Apnea Syndrome and Upper Airway Resistance Syndrome in Adults	08/14/2009
Surgery for Degenerative Diseases of the Cervical Spine	05/01/2009
Surgery for Morbid Obesity	01/01/2010
Surgical Treatment of Hyperhidrosis	10/01/2009
Surgical Ventricular Restoration	07/01/2009
Thermal Capsulorrhaphy as a Treatment of Joint Instability	01/01/2009
Total Facet Arthroplasty	03/01/2010
Transanal Endoscopic Microsurgery (TEMS)	12/08/2009
Transanal Radiofrequency Treatment of Fecal Incontinence	04/01/2009
Transcatheter Radiofrequency Ablation of Arrhythmogenic Foci in the Pulmonary Veins as a Treatment for Atrial Fibrillation	05/01/2009
Transciliary Fistulization for the Treatment of Glaucoma	02/01/2008
Transesophageal Endoscopic Therapies for Gastroesophageal Reflux Disease	12/01/2009
Transpupillary Thermotherapy for Treatment of Choroidal Neovascularization	12/01/2009
Transvaginal and Transurethral Radiofrequency Tissue Remodeling for Urinary Stress Incontinence	04/01/2009
Vagus Nerve Stimulation	01/01/2010
Varicose Vein Treatment	01/01/2010
Ventricular Assist Devices and Total Artificial Hearts	01/01/2010
Vertical Expandable Titanium Prosthetic Rib	12/01/2008
Wireless Pressure Sensors in Endovascular Aneurysm Repair	12/01/2009


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