Provider.healthlink.com

Medical Policies and Clinical UM Guidelines

WEBThe MCG guidelines we are licensed to use include ( (1) Inpatient & Surgical Care (ISC), (2) General Recovery Care (GRG), (3) Recovery Facility Care (RFC), (4) Chronic Care (CC) …

Actived: Just Now

URL: https://provider.healthlink.com/missouri-provider/medical-policies-and-clinical-guidelines

Full list of Medical Policies and Clinical Guidelines

WEBMedical Policy. Administrative. ADMIN.00006 Review of Services for Benefit Determinations in the Absence of a Company Applicable Medical Policy or Clinical …

Category: Medical Go Health

CG-SURG-83 Bariatric Surgery and Other Treatments for

WEBBariatric Surgery to Treat Indications Other than Obesity. The rates of metabolic diseases, such as diabetes and nonalcoholic fatty liver diseases (NAFLD) …

Category: Health Go Health

MED.00002 Selected Sleep Testing Services

WEBDescription/Scope. This document addresses selected services for the diagnosis of sleep disorders including: “Nap” studies. Actigraphy, including use of static …

Category: Health Go Health

CG-MED-19 Custodial Care

WEBThis document defines custodial care, a type of care that generally provides assistance in performing activities of daily living (ADL); for example, assistance walking, …

Category: Health Go Health

SURG.00132 Drug-Eluting Devices for Maintaining Sinus Ostial …

WEBThe use of drug-eluting devices for maintaining sinus ostial patency or the treatment of nasal polyps is considered investigational and not medically necessary for …

Category: Medical Go Health

CG-DME-40 Noninvasive Electrical Bone Growth Stimulation of the

WEBMedically Necessary:. Noninvasive electrical bone growth stimulation is considered medically necessary when all of the following criteria are met: . Treatment is …

Category: Medical Go Health

ADMIN.00002 Preventive MedRXweblines

WEBMedical Policy. Subject: Preventive MedRXweblines. Document #: ADMIN.00002. Publish Date: 06/28/2023. Status: Reviewed. Last Review Date: …

Category: Medical Go Health

CUSTOMIZATION TO CARE GUIDELINES 27th EDITION

WEBFebruary 16, 2023. This document provides a high-level summary of customizations and modifications to MCG Care Guidelines, collectively, “customized guidelines.”1234 The …

Category: Health Go Health

MED.00059 Idiopathic Environmental Illness (IEI)

WEBIdiopathic environment illness (IEI) has been labeled in a variety of ways over time including clinical ecology, multiple chemical sensitivity, universal allergy, 20 th …

Category: Health Go Health

CUSTOMIZATION TO CARE GUIDELINES 26th EDITION

WEBFebruary 17, 2022. This document provides a high level summary of customizations and modifications to MCG Care Guidelines, collectively, “customized guidelines.”1234 The …

Category: Health Go Health

CG-MED-84 Non-Obstetric Gynecologic Duplex Ultrasonography …

WEBMedically Necessary:. Non-obstetric, gynecologic, duplex ultrasonography of the abdomen or pelvis, in the outpatient setting, is considered medically necessary when …

Category: Medical Go Health

RAD.00064 Myocardial Sympathetic Innervation Imaging with or …

WEBThis document addresses use of the radiopharmaceutical tracer 123 iodine meta-iodobenzylguanidine (also known as 123 I-MIBG or MIBG, or AdreView ™) for …

Category: Health Go Health

CG-ADMIN-01 Clinical Utilization Management (UM) Guideline

WEBSubject: Clinical Utilization Management (UM) Guideline for Pre-Payment Review Medical Necessity Determinations When No Other Clinical UM Guideline Exists …

Category: Medical Go Health

SURG.00023 Breast Procedures; including Reconstructive Surgery

WEBDescription/Scope. This document addresses the following three areas: reconstructive breast surgery, cosmetic surgeries designed to enhance the appearance …

Category: Health Go Health

CG-DME-35 Electric Breast Pumps

WEBAn electric, heavy-duty, hospital-grade breast pump is recommended for mothers who are dependent on the expression of pumped breast milk (initiation or …

Category: Health Go Health

CG-MED-21 Anesthesia Services and Moderate (“Conscious”) …

WEBSubject: Anesthesia Services and Moderate (“Conscious”) Sedation. Guideline #: CG-MED-21. Publish Date: 01/03/2024. Status: Reviewed. Last Review …

Category: Health Go Health