Medical Policy Update Summary June 2019

Revised:

Medical Necessity Guidelines: Experimental, Investigational or Unproven Services

Title changed from “Medical Necessity Guidelines for Noncovered Investigational Services” to “Medical Necessity Guidelines: Experimental, Investigational or Unproven Services” to coincide with definitional enhancements.

Noncoronary Vascular Stents

Removed investigational designation for covered stents from Definitions and Limitations/Exclusions.

Osteogenesis Stimulators

Added indications of comorbid conditions and spondylolisthesis to electrical stimulation section.