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The Policy Bulletins listed below represent our catalogue of medical and claim payment policies. If you are looking for a specific type of policy, use the menu on the right to select a category and narrow your search.
For information about policy numbers click
here.
For information about medical policies, the technology evaluation process, and claim payment policies click
here.
Policy #
Policy Bulletin Title
09.00.04e
Bone Mineral Density (BMD) Testing
09.00.10m
Brachytherapy
09.00.42b
Computer Aided Detection (CAD) System for use with Chest Radiographs
09.00.32h
Diagnostic and Therapeutic Radiopharmaceutical Agents
09.00.52
Digital Breast Tomosynthesis
09.00.11b
Echocardiography Contrast Agents
09.00.02d
Electron Beam Computed Tomography (EBCT) for Screening Evaluations
09.00.36f
First-Trimester Prenatal Screening for Fetal Aneuploidy
09.00.24b
Full-Body Computerized Tomography (CT) Scan Screening
09.00.46e
High-Technology Diagnostic Radiology Services
09.00.13b
High Osmolar Contrast Agents
09.00.17g
Intensity Modulated Radiation Therapy (IMRT)
09.00.48
Intrahepatic Microspheres for Inoperable Liver Neoplasms
09.00.31c
Low Osmolar Contrast Agents
09.00.45e
Magnetic Resonance Imaging (MRI) Contrast Agents
09.00.28b
Magnetic Resonance Spectroscopy (MRS)
09.00.15e
Mammography and Computer-Aided Detection (CAD) System for Mammography
09.00.51
Positron Emission Mammography (PEM)
09.00.49b
Proton Beam Radiation Therapy
09.00.40b
Screening for Vertebral Fracture with Dual-Energy X-ray Absorptiometry (DEXA/DXA)
09.00.23b
Therapeutic Radiology Port Films
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