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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
The Blue Cross and/or Blue Shield Plans comprising The Regence Group serve Idaho, Oregon, Utah and much of Washington state.
The Regence Group and each of its affiliate Plans are independent licensees of the Blue Cross and Blue Shield Association.