Research And Markets: Study This Medical Review Criteria Guidelines For Managing Care, 4th Edition 2005 Now

The manual is actually accompanied from the entire contents on a CD.

- Dermatology: Dermatology referral management; Acne vulgaris; Actinic keratosis; Alopecia areata; Atopic dermatitis; Basal cell carcinoma; Biopsy/excision involving benign skin and also subcutaneous lesions, Cysts involving the skin as well as subcutaneous structures; Decubitus Ulcers, treatment; Digital Epiluminescence Microscopy (DELM)/Total body Photography; Fungus infections, skin and also nails; Dermatophytosis; Grenz Ray Therapy; Herpes Simplex; Herpes Zoster; Impetigo as well as pyoderma; Inflammatory dermatosis/'Rashes'; Head Of Hair Loss/Alopecia; Keloids;

- Neurology/Neurosurgical: Autism along with Some Other Pervasive Developmental Disorders; Sensory Stimulation regarding Coma; Facial Nerve Paralysis (Bell's Palsy) - Electrotherapy; Electroencephalogram (EEG) - standard, ambulatory, sleep-deprived, surgical, video; Electrocorticography (ECoG); brain mapping or perhaps Quantitive EEG for your diagnosis involving psychiatric disorders; Electromyelogram (EMG)/Nerve Conduction Velocity (NCV); Spinal Cord Injury Neuropsychological Screening (NPT); Stroke as well as other CNS Disorders; Somatosensory Evoked Responses, Vision Evoked Reaction test (VER), Deep brain electrical Stimulation for intractable tremors; Vision Evoked response test (VER); Multiple Sclerosis (MS) - Therapy, Web Sites; Multiple Sleep Latency Test (MSLT); Neuropsychological testing (NPT);

- Gastroenterology: Balloon Dilation of Gastrointestinal Tract Strictures; Colonoscopy, direct & Virtual: screening, diagnostic; Dysphagia - Evaluation involving swallowing mechanism; Electrogastrography (EGG); Endoscopic Retrograde Cholangiopancreatography (ERCP); Magnetic resonance cholangiopancreatography (MRCP); Endoscopic Ultrasonography; Upper, Lower; Esophagogastroduodenoscopy (EGD); flexible sigmoidoscopy; Gastroesophageal reflux disease (GERD); Intestinal Rehabilitation Programs; Implanted Capsule pH Monitoring regarding GERD;

- Radiation Therapy/Oncology: Radiation oncology; Mixture Chemotherapy and also Radiation Therapy; Brachytherapy; Brachytherapy for the Prevention associated with Restenosis inside Peripheral Arteries Subsequent PTA with the Femoropopliteal System; Intracoronary Brachytherapy; Breast Conservation Therapy within the Management of Invasive Breast Cancer; Neutron Beam Radiotherapy; Proton Beam Radiotherapy; Stereotactic radiosurgery; Transperineal Brachytherapy with regard to prostate cancer; Boron Neutron Capture Therapy (BNCT) for Glioblastoma Multiforme; Intensity Modulated Radiation Therapy; Radiation Therapy web sites.

Prostate Cancer therapy; Cancer With The Prostate Screening Assessments and Procedures; Prostate Particular Antigen (PSA); Benign Prostatic Hypertrophy - Treatment Method options; UroLume(R) endourethral prosthesis (urethral stent) for BPH, stenosis, strictures; Cryosurgical ablation in the prostate; Microwave therapy with regard to BPH; Transurethral Resection of the Prostate (TURP); Transurethral Microwave Thermotherapy (TUMT) regarding BPH; Transurethral Radiofrequency Thermotherapy/Needle Ablation in the Prostate (TUNA); Water-Induced Thermotherapy (WIT); Shock wave lithotripsy (Extracorporeal shock wave lithotripsy);

Papanicolaou tests/'Pap smears' with HPV DNA Screening regarding Cervical Cancer; Perineorrhaphy, Preimplantation Genetic Diagnosis; Pregnancy; Recurrent pregnancy loss; Presacral neurectomy (PSN) for the treatment method of chronic pelvic pain; Salivary estriol test pertaining to preterm labor, Salpingectomy/salpingostomy, VABRA aspirator; Ultrasonography within pregnancy, Ultrasonongraphy screen with regard to Down Syndrome, Uterine activity Monitoring (UAM), Uterine Fibroid (Leiomyomata) Therapy; Uterine artery embolization for the treatment involving fibroids; VABRA aspirator; Zinc blood ranges in pregnancy.

- Laboratory: Medicare Coverage associated with Laboratory Testing; Diagnostic testing, indications, coverage (HIV, PSA, Thyroid examples); Tau, BA-42 and also Apolipoprotein E assessments with regard to Alzheimer's disease; Substantial Sensitivity C-Reactive Protein (hsCRP); Anti-MAG as well as Anti-GM1 Antibody tests for Neurologic Disease; Cytogenetic studies; Human tumor cell assays (Fluorescent Cytoprint assay, Intense Drug Resistance assay); Genetic/Molecular Susceptibility Screening/Testing; Genetic screen for thyroid carcinoma and MEN; Genetic screen with regard to breast as well as ovarian cancer (BRCA1, 2); Genetic testing pertaining to cystic fibrosis; Genetic screening with regard to hereditary nonpolyposis colorectal cancer; Head Of Hair analysis; heavy metals and other minerals, test indications; Histocompatibility (HLA) testing; Iron/Ferritin Studies, Serum; Tumor markers; Lipid Profiles/Testing; Lyme Disease Testing; Laboratory References, general.

- Addenda: Operational Standards; Delegation in order to PCPs; Delegation for you to SCPs; New Healthcare Technologies Assessment - Policy/Procedure, Performance standards: QI/UM/Provider relations/Customer service; Critical Treatment - Medicare LMRP; Worker's Compensation; Hospital treatment 'length of stay' targets, by get older range; Frequency simply by Diagnostic/Procedural Group, Size associated with remain targets through DRG; NY State Medicaid ALOS through DRG 2004; Surgical Procedures, LOS benchmarks; Outpatient processes or even 'Same-day discharge' authorization list;

- Ophthalmology: A-scans, B-scans; Blepharoplasty, ptosis correction and also eyelid reconstruction; Capsulotomy; YAG laser; Cataract surgery; Preoperative Evaluation along with Screening pertaining to Cataract Extraction; Computer-assisted corneal topography; Conjunctivitis; Conjunctivodacryocystorhinostomy; Balloon Dacryocystoplasty/Dacryoplasty for Nasolacrimal Duct Obstruction; Make Contact With Lenses; Corneal graft utilizing amniotic membrane transplantation (AMT); Corneal pachymetry; Corneal post-transplant wound revisions; Corneal wedge resection;

Neuroimaging Research for Headaches; Metastatic bone disease - radiologic evaluation; Percutaneous Drainage/Aspiration of Abscesses and Fluid Collection; Percutaneous Permanent Inferior Vena Cava Placement; Percutaneous Transcatheter Embolization; Percutaneous Transluminal Angioplasty (PTA); Peripheral Vascular Disease Evaluation; Renal Artery Stenosis - Angiography as well as Stent Placement; Spiral CT regarding Lung Cancer Screening; Thermography;

Pediculosis ('lice'); Photochemotherapy for that treatment regarding scleroderma, extracorporeal; Pityriasis rosea; Psoriasis; PUVA Therapy; Rosacea; Scabies; Sclerotherapy with regard to varicose veins, Seborrheic dermatitis/'Dandruff'; Seborrheic keratosis; Squamous cell carcinoma; Tattoos; Verruca Vulgaris/ Warts; Vitiligo; Ultraviolet Any light Therapy; Ultraviolet B Mild Therapy.

Gonadotropin-releasing hormone therapy; HIV Drug susceptibility and also resistance testing; Hyaluronidase, intra-articular injections; Intravenous immunoglobulins (IVIG); IVIG for you to stop RSV; Cytomegalovirus Immune Globulin Intravenous, Human (CMV-IVIG); Interferon therapy; Intrathecal Baclofen regarding spasticity; Intravenous Histamine Therapy; Iontophoresis - applications throughout transdermal medication delivery;

- References along with Resources: positioned all through the actual manual - conveniently following each criteria or topic.

- Pharmacy: Pharmacy benefits; State regarding California Knox-Keene act requirements;

- Nephrology: Nephrology Consultation/Referral regarding ongoing care; Dialysis Therapy Pertaining To Renal Failure; Laboratory tests regarding CAPD; Arteriovenous fistulae for dialysis; ESRD coverage through Medicare vs. referrals; Guidelines; 'Evaluate and Treat' orders and also authorization requests; medical Necessity - What is it?; Case law citations associated to always be able to health-related necessity; AHRQ Prevention High Quality Indicators; Speed up the review process by ...; Hospital Inpatient Admission Criteria, general principles; 'Automatic' approval regarding authorization requests;

- Nutritional: Nutrition Counseling/Educational Programs; Specialty foods, Liquid nutrition products; Ketogenic diet plan counseling pertaining to refractory seizure control; Lower protein food products; Extremely low fat diets in order to treat as well as stop heart disease; Supplemental Fasting Regimens; Enteral Nutrition/Tube feeding; Parenteral nutrition/Total Parenteral Nutrition (TPN); Internet helpful info on meals along with nutrition;

Morbid Obesity/Bariatric Surgery; Assortment pertaining to surgery based on comorbid diabetes and hypertension furthermore to become able to BMI;

- Skeletal-muscular system: Knee region: Arthroscopy - knee; Arthroscopic lavage or even debridement, knee; Total Knee Replacement; Autologous chondrocyte transplantation surgery with the knee; Hyaluronidase, intra-articular injections for osteoarthritis;

Speech aids, electronic; Thairapy O vest with regard to cystic fibrosis; Thairapy Bronchial Drainage System; Therabite Jaw Motion Rehabilitation System; Therapeutic Electrical Stimulation/TES; Transcutaneous Electrical Nerve Stimulation/TENS; Inferential present stimulation; Non-Implantable Pelvic Ground Electrical Stimulator; Implanted Peripheral Electrical Nerve Stimulation; Percutaneous Electrical Nerve Stimulation/PENS; Electrical Stimulation with regard to Chronic Musculo-cutaneous Ulceration; Respiratory Assist Devices; Standers, Boards as well as Tables; Vitrectomy Deal With Support; Wheelchairs, Power-type along with Power-operated vehicles (POVs); Wigs; DME Screening Checklist - a new grid listing 290 additional DME/DMS review guidelines; Reuse Info Notice.

- Radiology: Documentation requirements; Imaging guidance during surgical procedures; Bone Mass Measurement/Bone mineral density (BMD) testing; Skeletal surveys in children; Cardiac scans pertaining to CAD; Cerebral angiography; Chest x-rays, routine; contrast media; Spine - diagnostic radiology in adults as well as children; Imaging studies in acute low back pain; Myelography along with Cisternography; Discography; Scoliosis in children - indications with regard to radiography; Epidurogram/Epiduroscopy;

Impotence evaluation as well as treatments: Viagra; Noninvasive suction devices; Papaverine injections; Penile prosthesis implantation; Electroejaculation; Internal Pudendal Arteriography (Angiography) pertaining to Erectile Dysfunction; Percutaneous Nephrostomy;

Hyperbaric Oxygen Therapy; Immunizations; Injectable Medications; Laser procedures; Miscellaneous services - Medicare Time Frame pertaining to Payment Denial; Multiple Chemical Sensitivity Syndrome or Idiopathic Environmental Intolerances (IEI); Organ and Tissue Transplantation - bone marrow, intestinal, strong organs; Outmoded exams and also procedures; Pain rehabilitation programs; Outpatient Hospital Pain Rehabilitation Programs; Physician's Workplace within an Institution--Coverage associated with services along with Provides Incident into a Physician's Services; 'Second opinions'; Sleep disorders- testing; Transportation, medical/Ambulance transports;

Canadian drugs; Formulary; MAC pricing; Generic substitution; Alpha 1-antitrypsin inhibitor therapy; Anticoagulant Therapy - Monitoring; Biologicals; Hepatitis vaccines; Growth hormone replacement (adults and children); Botulinum toxin; Calcitriol; Cancer chemotherapy; Erythropoeitin Therapy; Experimental Drug Therapy; Chelation therapy; Diabetes management therapy/supplies; Diabetic foot ulcers - Regranex gel therapy;

Foot as well as ankle: Bunionectomy; Foot treatment - routine; Mycotic nails; other covered services for the foot as well as ankle; Ingrown toe nails; Olecranon bursa aspiration; Plantar Keratosis; Interdigital Neuroma; Plantar fasciitis and also heel spurs; Consultation services by method of a podiatrist - skilled nursing facility; Hammertoe surgery; Fractures with the toe; Maxwell-Brancheau Arthroereisis (MBA) Implant - regarding flat-foot;

- Note: Review criteria guidelines or even 'benefit interps' are helpful resources for claims payment choices to end up being able to base medical necessity decisions, particularly if little if any preauthorization perform or perhaps info exists also as utilization management, educational as well as precertification tools. These People should be distributed in order to relevant physicians and other providers with regard to review, input and then any necessary adjust prior to implementation. Most needs for you to be reviewed as well as approved with a Healthcare Policy Committee of the purchasing organization ahead of use. Modification associated in order to neighborhood clinical circumstances or even regards to applicable certificates associated with coverage or perhaps provider contracts may become proper and also necessary.

Transrectal ultrasound regarding prostate or rectal cancer - biopsy/staging; Pelvic Ultrasound throughout Females; Sonohysterosalpingraphy; Obstetrical Ultrasonography; Scrotal Ultrasonography; Retroperitoneal Ultrasonography; Developmental Hip Dysplasia Detection through Ultrasonography; Ultrasound involving peripheral websites (tibia, phalanges) for that collection of patients regarding pharmacologic treatment associated with osteoporosis; Radiology guideline resources/web links.

- ENT, Oral Surgery as well as Dental Services: Acoustic neuroma; Audiological Testing; Aural Rehabilitation Therapy; brain stem auditory evoked reaction (BER, BAER); Carbogen Inhalation Therapy for your Remedy associated with Sudden Hearing Loss; Cleft lip/Cleft Palate Repairs; Cochlear Implantation; CPAP pertaining to obstructive sleep apnea; Noninvasive Positive Pressure/Bi- PAP; Dental services; Dental hospitalization; Damage for you to sound and also All-natural Teeth; Intra-oral appliances for that management regarding migraine headache syndromes; Dynamic Posturography;

Carpal Tunnel Syndrome - conservative therapy; Carpal Tunnel Release; Cranial Electrical Stimulation; Embolization involving intracranial aneurysms; Electromyelogram (EMG)/Nerve Conduction Velocity (NCV); Anal or Urethral Sphincter Electromyography; Sensory Evoked Potentials; Ketogenic diet program for that control of intractable seizures within children; Peripheral neuropathy with loss of protective sensation (LOPS); H-wave stimulation for the management regarding chronic diabetic peripheral neuropathy;

- Blood Bank: Autologous Blood-Derived products pertaining to Chronic Non-Healing Wounds; Blood transfusions; autologous, allogeneic, donor directed; Cord blood storage; Granulocyte along with Platelet Transfusions; Plasmapheresis, plasma exchange, apheresis and associated procedures; Lipid apheresis; Nonselective (random) transfusions along with living-related donor specific transfusions throughout kidney transplantation; Therapeutic Phlebotomy

Stimulators: Chronic pain, Angina pectoris; treatment involving Motor Operate Disorders together with Electric Nerve Stimulation; Neuromuscular electrical stimulation (NMES) for disuse atrophy; Neuromuscular or perhaps Therapeutic Electrical Stimulation (TES); Transcutaneous electrical nerve stimulation (TENS); 'Sympathetic Therapy'; Inferential existing stimulation; Non-implantable Pelvic floor Electrical Stimulator; Percutaneous electrical nerve stimulation (PENS); ReliefBand; Implanted Peripheral Electrical Nerve Stimulation; Pulsed electrical stimulation regarding osteoarthritis in the knee; Electrical Stimulation for your Therapy associated with Wounds: Chronic Stage III & IV Musculo-Cutaneous Ulcerations; Surface electrical muscle mass stimulation; Bone stimulators: electrical as well as low-intensity ultrasound; Electrogalvanic Stimulators for Levator Syndrome; H-wave stimulation for the therapy associated with diabetic neuropathy;

Orthotic/prosthetic devices; Breast prosthesis, specialized bras for ladies post-mastectomy; Corset Employed as Hernia Support; Dynamic Splinting Devices; Foot orthotics/therapeutic shoes; Magnetic insoles regarding plantar heel pain; Myoelectric prosthesis, upper extremity;

Electroencephalographic biofeedback pertaining to intractable seizures; Epiduroscopy; Fetal Tissue Transplantation for your Therapy involving Parkinson's disease; Pallidotomy for your treatment method involving Parkinson's disease; Fetal Tissue Transplantation for the Treatment Method involving Parkinson's disease; Surgical evaluation for intractable seizure disorders - Grid monitoring; Deep Mind electrical Stimulation with regard to intractable tremors; brain mapping (quantitative EEG) with regard to diagnosis associated with psychiatric disorders;

Diagnostic radiology - general; Extremity x-rays; Knee trauma; Diagnostic Arteriography - Indications; Cervicocerebral angiography; Digital subtraction angiography (DSA); Infusion Venography; resources for Angiography Indications; Abdominal and Gastroenterological X-ray Procedures; Cholescintigraphy (HIDA); Cinedefecography; Herniography; Urological: Intravenous Pyelography (IVP); Cystography along with Urethrography; Voiding cystourethrography within Children;

Electronystagmogram (ENG); Ernest or even Eagle's Syndrome/Stylomandibular Ligament Pain - Remedy using Radiofrequency Thermoneurolysis; Frenulectomy; Hearing Tests,; Impacted teeth - extraction; Intra-operative Electromyographic Monitoring associated with Cranial Nerves; Laser assisted Uvulopharyngoplasty (LAUP); Myringotomy using Tympanostomy Tubes/Laser Myringotomy; Meniett 20 pertaining to overpressure therapy involving Meniere's Disease;

Cognitive Rehabilitation Therapy; Constraint-induced movement therapy (CIMT); Hippotherapy/Therapeutic Horseback Riding/Equestrian Therapy; Hypothermia subsequent acute brain injury; Induced Lesions involving Nerve Tracts; Intra-operative Electromyographic Monitoring involving Cranial Nerves; Invasive Intracranial pressure Monitoring; Ulnar Nerve Transposition, Decompression or perhaps Release; Monitoring; Ulnar Nerve Transposition, Decompression as well as Release; Vagus Nerve Stimulation for the treatment method involving refractory seizures; Vagus Nerve Stimulation for your treatment method associated with depression; Videopupillography/Tropicamide Drop Test for that Diagnosis of Alzheimer's Disease; Perception Threshold/Sensory Nerve Conduction Threshold (SNCT);

- Educational materials: General educational materials, Affected Person Schooling materials Policy - Development, Approval along with Review, Institutional and also home care patient Education And Learning Programs; Healthcare 'Self Care' Educational Programs; Training lessons for OB patients; the 'Not Now!' Program; Institutional and home Treatment Individual Education And Learning Programs; Medicare Coverage associated with Diabetes Self-management Training.

Back and also Neck: Acute cervical pain; Synthetic Intervertebral Disc; Laminectomy ; low back again pain; Machines to test as well as treat low back again pain; Chymopapain Chemonucleolysis; Endoscopic Anterior Spinal Surgery; Epidural injection involving steroids with regard to back again pain; Facet Joint Injections; Facet Denervation, Facet Neurotomy, Facet Rhizotomy, or perhaps Articular Rhizolysis; Hypertonic saline for your treatment of epidural adhesions, adhesive arachnoiditis, as well as failed back syndrome; Implantable Infusion Pumps with regard to Treatment Method of Chronic Severe Again Pain; Intradiscal Electrothermal Therapy (IDET); Laminectomy; Meniscectomy; Microdiscectomy; Percutaneous Lumbar Discectomy, such as laser procedures; Percutaneous vertebroplasty and kyphoplasty; Prolotherapy; Spinal instability - Pedicle screw fixation; Spinal stenosis; Sacro-iliac Joint Injections; Chiropractic Medicine; Distraction osteosynthesis, Ilizarov method; Spinal manipulation beneath anesthesia;

Shoulder: Shoulder Arthrography; Arthroscopy, shoulder; Electrothermal arthroscopic repair pertaining to shoulder instability; Impingement Syndromes, Shoulder Bursitis, Rotator Cuff Tendinitis & Tears; Ultrasound therapy with regard to calcific tendinitis in the shoulder;

- Complementary as well as Alternative Medicine: Alternative medicine criteria; Acupuncture/Acupressure; Ayurvedic medicine; Biofeedback; Biofeedback for Urinary Incontinence; Magnetic and Bioelectromagnetic Therapy; Diet Program along with Nutrition; Guided imagery; Homeopathy; Hypnotherapy; Manual/massage therapy; Naturopathy; Relaxation therapy; Transcendental meditation; Alternative medicine resources; references; web sites; source organizations;.

- Urology - review criteria: Referral guidelines; BCG therapy with regard to bladder cancer; Urinary FISH Test for Recurrent Bladder Cancer; Valrubicin with regard to carcinoma in-situ with the bladder; Bladder stimulator/Pacemaker implantation; Bladder pacemakers; Bladder Capacity Ultrasound (Post-void Residual Measurements); Circumcision in the adult male; Cystoscopy; Bladder biopsy, transurethral;

- Nuclear Medicine: Bone scan; CEA scans; Cardiac Scans - Introduction/Overview, Medicare LMRP; Cardiac scans - thallium and gated pool scans; Cerebral Scintigraphy pertaining to Mind Death; Cholecystokinin Cholescintigraphy/Hepato-biliary scintigraphy; Gastrointestinal scintigraphy; Gated Pool Scan; Indium-III Oxine labeled white blood cells scan; Liver spleen scan; Monoclonal Antibody (Mab) Imaging/Radioimmunoscintigraphy which includes Scintimammography; Parathyroid scintigraphy;

- Pediatric: Pediatric authorization guidelines with regard to Lengths regarding stay; Apnea monitor; Circumcision in the newborn male; Cord blood testing; Cystic fibrosis screening inside newborns; Diabetes mellitus - Assessment regarding Want pertaining to Hospitalization for that Stabilization involving Recently Diagnosed children with Diabetes; Diabetes Management Utilizing 'Hepatic Activation' or 'PIVIT' Therapy; Comprehensive pediatric case management services; Early Intervention Programs; Extracorporeal membrane oxygenation (ECMO); Hearing Screening, Newborn; Immunizations, Lead screening - blood - children; Newborn LOS - when infant healthy, Mother demands continued hospital care; Phototherapy; Physician Attendance in Delivery with regard to Evaluation and also Management of Newborn; Port Wine Stains.

Age-related Macular Degeneration (AMD); Macular degeneration: Laser Therapy; Radiation Treatment; Macular Fovea Translocation for AMD; Ocular Photodynamic Therapy (OPT) - Visudyne (Verteporfin) Therapy with regard to Age-related Macular Degeneration; Opthalmoscopy, extended along with retinal drawing Orbitotomy; Photocoagulation; Pterygium; Ptosis; Punctal dilation/snipping; Punctal Plugs and also Punctoplasty regarding 'Dry Eyes' Syndrome; Corneal remodeling treatments - Refractive Keratoplasty/Radial Keratotomy/Phototherapeutic Keratectomy; Refractive Keratoplasty/Radial keratotomy; Prosthesis, eye; Eye Examinations - Medicare; Routine vision exam; Scleral buckle; Strabismus correction; Tarsorrhaphy; Transpupillary Thermal Therapy; Viscocanalostomy; Visual Area Testing; Visual training (Orthoptics); Visual Rehabilitation Program; Vitrectomy; Referral criteria summary sheet/grid pertaining to common complaints.

Ultrasonography: Overview; Noninvasive cerebrovascular studies of extracranial arteries; Paranasal sinus ultrasonography; Spinal canal Shemale Cam Chat as well as contents ultrasonography; Peripheral Arterial Ultrasound Examination Utilizing Pulsed Doppler; Peripheral Venous Ultrasound Examination; Thyroid and also Parathyroid Ultrasonography;

- multiple gestation reduction; Amniocentesis; Cervical cerclage; Cervicography (cervigram); Cesarean section - elective; Chorionic villus sampling; Colposcopy Immediate access for OB/GYN services, Dilation and Curettage (D & C), D & C additionally hysteroscopy, D & C, Hysteroscopy as well as pelvic laparoscopy - exact same day; Family Members Planning services - birth manage devices and also genetic counseling, Norplant, Oral contraceptives - sterilization - tubal ligation/vasectomy, Sterilization - Tubal ligation as well as vasectomy, OTC products; Fetal fibronectin screening for preterm labor and also delivery risk; Genetic Counseling and Testing; Residence births; Hysterectomy; Outpatient hysterectomy; Hysteroscopy/Hysterosonography;

Oral surgery; Oral biopsy regarding malignancy; Orthodontia; Orthognathic surgery; Distraction osteogenesis for craniofacial abnormalities; Otitis media, recurrent; Otoplasty; Positional vertigo; Rhinomanometry as well as acoustic rhinometry/Nasal function Studies; Septoplasty; Septorhinoplasty; Sialorrhea (drooling) - Surgical Treatment; Sinusitis, acute; Sinus endoscopy, using or without having computer-augmentation; Smell as well as Taste - Evaluation coverage;

Incontinence - defined; artificial Urinary Sphincter; Strain incontinence - Electrical stimulation in the pelvic floor; Sacral nerve stimulation with regard to urge incontinence; Transurethral/Periurethral collagen implantation for stress urinary incontinence; Marshall-Marchetti Kranz, Burch, Stamey and comparable procedures; References - Urinary Incontinence; Transrectal ultrasound with regard to prostate kind of cancer - biopsy/staging; Renal Cryoablation; Transrectal ultrasound for prostate cancer; Transsexual surgery; Urethral Dilation - female; Urodynamic Testing;

Breast imaging studies: Diaphanography in the breast; Mammography, screening or perhaps diagnostic/Digital/CAD mammography; Magnetic Resonance Imaging with the Breast: Differential Diagnosis; Breast Ultrasound as well as Echography; Stereotactic Breast Biopsy;

Selective peripheral denervation (Bertrand procedure) with regard to spastic torticollis; Spinal tap, diagnostic, Stereotactic Cingulotomy, pertaining to severe and intractable pain thanks for you to terminal cancer; Sympathetic therapy regarding chronic pain management; Sympathetic therapy for chronic pain management; Sympathectomy, Thoracoscopic; Thalamic Electrical Stimulation, for your remedy of intractable tremors; Transcranial Doppler Ultrasonography; Transient Ischemic Attack (TIA) - Hospitalization Indications; Trigeminal Neuralgia, Cryosurgery;

Endothelial cell photography; Entropion; Ectropion; Enucleation; External Ocular Photography; Glaucoma treatment; Optic Nerve Head Topography - Confocal Laser Scanning Tomography, Stereophotogrammetry; Argon Laser Trabeculoplasty; Aqueous drainage/shunt implants pertaining to refractory main open-angle glaucoma; Gold weight Upper Eye Lid Implants; Grave's Disease Ophthalmopathy; Indocyanine Green Angiography; Intraocular Lens Implant; Iridotomy/Iridectomy; Keratoconus; Keratoplasty; Keratoprosthesis or perhaps artificial Cornea;

- Allergy Screening along with Desensitization: Allergy referral, Allergy screening along with desensitization therapy; Serial Endpoint Allergy Testing; Immunotherapy pertaining to malignant disease; Leukocyte Histamine Launch Test (LHRT); Screening for Hypersensitivity Reactions to foods as well as Chemicals, Throughout Vitro Particle Dimension Measurement; Nasal Challenge Test; Rhinitis, allergic - referral criteria; Transfer factor.

- Cardiology: Acoustic heart Scans/Recordings; Ambulatory blood pressure

- Pulmonary: Pulmonary function tests; Quantitative pilocarpine iontophoresis sweat test; Duration IV antibiotics with regard to pneumonia; Electrophrenic Pacemaker; Fiberoptic bronchoscopy; Lung volume reduction surgery; Sleep apnea studies/Polysomnography; Sleep apnea studies, portable; BiPap; Phrenic nerve pacing/Diaphragm pacing; Positive Expiratory pressure (PEP) for Cystic Fibrosis Therapy; Noninvasive Positive-Pressure Ventilation (NPPV) pertaining to COPD; Postural Drainage Treatments and Pulmonary Exercises; Pulmonary Rehabilitation; Outpatient Pulmonary Rehabilitation (PR); COPD guideline sources along with links; 'Virtual' Lung Scans.

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Other Skeletal-muscular: Extracorporeal Shock Wave Therapy (ESWT) for musculo-skeletal conditions; Apligraft (R) (Graftskin) Medicare LMRP; Carpal tunnel release; Trigger Point Injections; Total Hip Replacement (THR) - Primary, excluding hip fracture, indications, LOS; Bone stimulators, electrical and low-intensity ultrasound; Gait analysis or possibly the electrodynogram; Injection, tendon sheath, ligament, or perhaps trigger factors or even ganglion cyst; Injection associated with joints; Osteogenic protein-1 for that treatment method associated with nonunion fractures;

DUBLIN, Ireland--(BUSINESS WIRE)--Feb. 10, 2005--949 pages include a lot a lot more than 1,200 clinical 'benefit interps'/ review criteria clinical guidelines. The Actual manual can be made for use as possibly any prospective utilization management reference, an educational tool, or perhaps pertaining to retrospective claims payment review resource.

Research along with Markets ( features announced the supplement of Healthcare Review Criteria Guidelines pertaining to Managing Care, 4th edition 2005 to their offering

- Disposable Health-related Supplies/Durable Health-related Equipment: Medicare Coverage Criteria for DME; Disposable Health-related Materials (DMS): Incontinence supplies; Urinary Drainage Systems; Porcine Skin along with Gradient Stress Dressings; Ostomy supplies; Unna boot;

- Miscellaneous: Assisted Suicide; Autopsies; Cryoanalgesia as well as Cold Laser (low-energy) Therapy with regard to wound healing, pain therapy, as well as other disorders; Complications next Non-covered Solutions - Coverage; Hospital charges pertaining to Noncovered Services; Death-related Services; Electrosleep Therapy; Experimental/Investigative Services; Histamine desensitization therapy with regard to intractable headache; Hospital Admission Guidelines regarding Diabetic Adults;

Transendoscopic gastroplasty; Stretta as well as EndoCinch Procedures; Fecal Occult Blood test, screening - positive; Fiberoptic endoscopy for the evaluation associated with swallowing; Gastric freezing for the treatment method of active peptic ulcers; Gastrostomy/PEG tubes; Capsule Imaging Endoscopy/Wireless - Medicare LMRP; Injection Sclerotherapy for bleeding esophageal varices; Gastric Pacing; Liver Biopsy; Liver assist or perhaps assistance devices; Motility Disorders: Upper GI - Diagnosis/Evaluation; Transesophageal Endoscopic procedures regarding Gastroesophageal Reflux (GERD); Transjugular Intrahepatic Portosystemic Shunt; Transplantation; Urea breath screening pertaining to H. pylori infection.

Oxygen coverage guidelines; Peak expiratory flow meter; Pneumatic Compression Therapy - End-diastolic regarding non-healing extremity ulcers; pressure Decreasing Assistance Surfaces, Team 1 as well as 2; Computerized lower limb prostheses; Prothrombin time House Screening Systems;. Wellness Plan; Darbepoetin Alfa (Aranesp); Intravenous Iron Therapy; Medicare ESRD Coverage - algorithm; Hemodialysis for the remedy of hepatorenal syndrome; Hemodialysis for the therapy associated with schizophrenia; L-carnitine supplementation; Nephrology web sites.

- Hematology/Medical Oncology: Hem-Onc Authorization Guideline Notes; Adjuvant Chemotherapy; Adoptive immunotherapy (AIT); Bone marrow/Stem cell transplant (BMT); Umbilical cord blood compatibility testing; Chemoresistance assays/Tumor chemosensitivity; Chemotherapy vs Endocrine Therapy pertaining to Metastatic Breast Cancer; Cryosurgical ablation hepatic lesions; Dendritic cell immunotherapy regarding cancer; Donor Lymphocyte Infusions; Epithelial Cell Cytology inside Breast Cancers risk Assessment and also High-Risk Affected Person Management; Extracorporeal Immunoadsorption; Extracorporeal Photopheresis; Hematopoietic colony-stimulating factor/Granulocyte-macrophage colony-simulating factor; Hyperalimentation for patients receiving chemotherapy; Hyperthermia; Hypothermia (regional scalp cooling) - chemotherapy-associated locks loss;

Echocardiograms, adult along with pediatric; Doppler Echocardiography; Electrocardiograms; Electrophysiology screening (ET); Endocardial Shemale Cam Chat electrical recording as well as stimulation (EES), diagnostic; Enhanced external counterpulsation (ECP) - remedy with regard to severe angina; Physical exercise Treadmill Test (ETT), routine screening; Exercise Treadmill Test (ETT) - routine, screening; ETT using Thallium imaging; Pacemakers - permanent cardiac/Resynchronization Therapy; Pacemaker monitors; Pacemakers/External manually activated devices in order to terminate tachyarrhythmias; Percutaneous Transluminal Coronary Angioplasty (PTCA); Radiofrequency Catheter Ablation; Stents, coronary artery; Thoracic electrical bioimpedance; Thrombolysis with regard to acute myocardial infarction; Tilt Table Testing; T-Wave Alternans (TWA) testing; Cardiac Rehabilitation Programs; Phonocardiography and Vectorcardiography; LOS benchmarks/targets regarding cardiology diagnoses; References re: AMI LOS; Screening for cardiac disease; Cardiology guideline resources, web links.

Electrical Stimulation DME include: Dorsal Column Stimulators/Spinal Cord

- Obstetrics/Gynecology: Ablation - cervical lesion; Abortion/pregnancy termination

Cardiovascular Nuclear Medicine studies; Congestive Coronary Heart Failure - admission, discharge criteria guidelines; CT scans to always be able to screen for coronary artery disease; Congestive heart Failure - Hospital admission criteria; Defibrillator devices, automatic implantable cardioverter; direct present cardioversion, elective; Directional coronary atherectomy (DCA);

- Plastic Surgery: Abdominoplasty/Panniculectomy Breast surgery - Implant removal and/or replacement; Gynecomastia reconstruction in the male patient; Augmentation mammoplasty; Reduction mammoplasty or perhaps breast reduction surgery; Liposuction: Lipectomy, Suction-assisted; cosmetic surgery; Chemical exfoliation or perhaps peel; Aesthetic laser surgery; Cutaneous Ulcer, Chronic - Electrical Stimulation; Ear lobe deformities; Head Of Hair transplantation; Mentoplasty (Chin Augmentation, Genioplasty); Plastic Surgery in order to Appropriate "Moon Face"; Porcine Skin and also Gradient pressure Dressings; Reconstructive surgery - general criteria; Scar revisions; Skin redundancy following enormous excess weight loss.

- Emergency health-related services: Emergency services/authorization system, Emergency room authorization/claims processing matrix, Emergency treatment method criteria; Relationship associated with ER admissions in order to insurance status; Ambulance along using other medical transportation;

Non-contact Normothermic Wound Therapy (NNWT); 'Second Look' surgical procedures; Thyroidectomy; Post-op LOS by simply procedure, list; Inpatient days Prior to some Surgical Procedure; Exactly Where should a higher-risk procedure become performed inside a specific individual as well as population regarding patients?

Immunotherapy to diminish the actual likelihood of spontaneous abortion; Infertility management: Coverage criteria for females, Coverage criteria for males, Infertility treatment, artificial insemination, Ova sticks - ovum transfer/uterine lavage - sperm donor/storage/washing; Intracytoplasmic sperm injection; In-Vitro Fertilization (IVF) as well as Gamete Intra-Fallopian Transfer (GIFT); Multifetal pregnancy reduction (MFPR); Recurrent Pregnancy Loss; Transcervical balloon tubuloplasty; Intra-uterine device (IUD) - removal, Laparoscopy - pelvic; Myomectomy; Nerve Ablation Methods for Dysmenorrhea, Laparoscopic; Laparoscopic, Oophorectomy;

Temporomandibular Joint Disorders (TMJ); Tinnitus Retraining Therapy; Tonsillectomy and/or adenoidectomy; Transcutaneous electrical stimulators for severe tinnitus; Transtympanic Gentamicin Injection pertaining to therapy of Meniere's disease; Tympanometry; Tympanostomy tubes; Ultrasonic Surgery with regard to Meniere's; Uvulopalatopharyngoplasty (UPPP) along with palatopharyngoplasty (PPP); Vestibular Perform Testing; Vestibular Rehabilitation; Vocal Cord Examination using Videostroboscopy; Vocal Cord Injections in order to prevent Recurrent Aspiration.

Positron Emission Tomography (PET scans); Pulmonary Scintigraphy; Prostate cancer staging scan; Renal Scintigraphy; Scrotal scintigraphy; Sentinel Lymph Node

Durable medical Equipment (DME): Definitions; Stress Lowering support Surfaces, groups 1, 2, and also 3; Air Fluidized Beds; Bathroom and Toilet Equipment and also Supplies; Beds and Mattress Accessories/Trapeze Bars; Bed along with Pillow covers for Asthmatics; Bed-wetting Alarm; Breast Pumps; Catheters, urinary; --Cervical traction; Chairs, therapeutic; Communication devices/aides; Compression Garments in the Therapy regarding Venous Stasis Ulcers; Steady Passive Motion device; Cranial Remodeling Band/Helmet regarding infants; Dorsal Column Stimulators - pertaining to chronic intractable pain control; Diabetes mellitus-related DME - Glucose monitors, blood; GlucoWatch(R) Biographer - automatic glucose values with out any needle-stick; Jet Injectors with regard to insulin administration; Insulin pens; Sleep sentry to detect hypoglycemia; continuous Glucose Monitoring;

MRI Studies - Overview; 'Standing' as well as 'Sitting' MRI Scans; MRI Brain; MRI Orbit, Face, and Neck; MRI Spine; MRI/MRA - Cardiovascular studies; MRI Abdomen and also Pelvis; Tumor staging; Table citing optimal imaging studies simply by region; CT Angiogram; MRI as well as CT-guided biopsies; Magnetic Resonance Angiography (MRA) including Venography; Magnetic resonance spectroscopy/Nuclear magnetic resonance; Magnetic Supply Imaging (MSI)/Magnetoencephalography (MEG);

- General Surgery: Clinical Guidelines pertaining to Office-based Surgery; Anal fissure, chronic; Appendectomy; Breast surgery - biopsy; Mastectomy; Cholecystectomy, open up or laparoscopic; Colon resection - Colectomy, Debridement, Wound; Gastroesophageal Reflux Device Implantation, Gastroesophageal Reflux (GERD) Surgery; Hemorrhoidectomy - internal along with external, Hiatal Hernia repair, Incisional Hernia Repair, Inguinal Hernia Repair, Umbilical Hernia Repair, Incision and Drainage (I & D) Procedures; Laparoscopy or even Peritoneoscopy;

monitoring; Ambulatory electrocardiography (Holter monitor); Brachytherapy, Coronary; Cardiology consultation or perhaps referral; Chest pain - admission criteria, Cardiac catheterization, correct heart; Central venous pressure monitoring, Cardiac Catheterization, proper heart, Central venous strain monitoring; Cardiac Catheterization, left heart; Coronary Arteriography; Angiography as well as Ventriculography; Cardiac Event Monitors; Implanted Loop Recorders; Catheter ablation for atrial fibrillation along with HF; Cardiac Tranny Cam Models Output Monitoring by simply Electrical Bioimpedance ;

- Vascular Laboratory: Noninvasive cerebrovascular studies involving extracranial arteries; Carotid function - non-invasive tests: Duplex scan associated with carotid arteries; vertebral arteries; Ocular Plethysmography (OPG) and also Ophthalmodynamometry; Transcranial doppler, Penile doppler as well as Corpora Cavernosography, Peripheral arterial non-invasive studies: Segmental Doppler Pressures and Pulse Volume Recording; Workout (Stress) Doppler Test; Visceral arterial duplex imaging; Peripheral Arterial Duplex Scan; Digital Arterial Evaluation; Peripheral venous and also arterial non-invasive studies/ultrasonography; Peripheral Arterial Ultrasound Examination Utilizing Pulsed Doppler; AcuTect/Scintigraphic Imaging for Detection/Localization regarding Lower Limb Deep Vein Thrombosis;-- Hemorheograph.

MRI and CT scans - Computerized Tomography (CT) as well as Computerized TS Cams Axial Tomography (CAT) - Overview; Computerized Tomography (CT or CAT) including extracranial head, brain along with thoracic scans; High-resolution CT (HRCT) pertaining to Pulmonary Studies; CT regarding appendicitis; Spiral CT Scans regarding Lung Cancer Screening; Helical CT pertaining to Pulmonary Embolism Detection; Computerized Axial Tomography (CT) Scans: Pelvis, Abdomen, Abdomen along with Pelvis - on the exact same day; Electron-beam CT screening with regard to coronary artery disease; Ultrasound of peripheral sites (tibia, phalanges) for your choice of patients with regard to pharmacologic remedy associated with osteoporosis;

Low molecular excess weight heparin; Lyme disease vaccine; Meningococcal vaccine; Mifepristone (Mifeprex(TM), RU 486); Nicotine patch, gum as well as nasal bottle of spray therapy for smoking cessation; Off-label drug therapy; Oral contraceptives; Phonophoresis; Prior authorization list w/indications; Platelet-derived Growth Aspect regarding Wound Healing (Regranex, Procuren); Prophylactic antibiotics; Prostacyclin infusion therapy; Sexual perform therapy; Smallpox Vaccination; Topical steroids; Transfer Factor; Tumor Necrosis Aspect Inhibitors - Ankylosing Spondylitis, Ulcerative Colitis, Psoriasis; Injectable drugs; Pharmacy web sites.

Laser with regard to actinic lesions; Malignant melanoma; Mohs Micrographic Surgery;

Impedance plethysmography; Intermittent claudication; Intraoperative Ventricular Mapping; Left Ventricular Assist Devices; Maze Procedure pertaining to atrial fibrillation/flutter; Microsurgical lymphaticovenous anastomosis operation regarding lymphedema; Pectus excavatum as well as Pectus carinatum - Surgical Correction; Photophoresis, extracorporeal - Therapy for heart Transplant Rejection; Post-thoracotomy Pain - Intraoperative, Intercostal Nerves, Cryoanalgesia; Pulmonary vein isolation with regard to atrial fibrillation; Renal Artery Stenosis - Angioplasty, Stent Placement; Transcoronary ablation involving septal hypertrophy (TASH); Transjugular Intrahepatic Portosystemic Shunt; Transmyocardial laser revascularization; Varicose vein processes including Endovenous Ablation Therapy; Ventricular Assist Devices; Ventricular Reduction/Remodeling or perhaps Partial Ventriculectomy; Vertebral artery surgery; Peripheral vascular rehabilitation programs.

- Detection, Biopsy; Melanoma/Breast Cancer Staging; Scans regarding Infection as well as Inflammation; SPECT scans; Thyroid studies; Tumor Scintigraphy (Gamma Camera).

Lifts - seat and patient; Mild Emitting Diode (LED) or perhaps Infrared Therapy; Lymphedema 'Pump'/Manual lymph drainage; Magnetic Pelvic Ground Stimulation (MPFS); Nebulizers; Wound Care; Negative stress wound therapy (NPWT) Pumps; Radiant Heat Wound Therapy Systems; Neuromuscular electrical stimulation (NMES);

- Cardiovascular/Peripheral Vascular Surgery: Alcohol Septal Ablation pertaining to Hypertrophic Obstructive Cardiomyopathy; Aortic Aneurysm Repair - Criteria and also Options; Aortic and/or valve replacement; Atherectomy, peripheral; Atrial septal defect, repair; Carotid body tumor resection (Glomectomy); Carotid endarterectomy - Indications, LOS; Carotid/Vertebral Artery Angioplasty and Stenting Procedures; Coronary artery bypass graft(s) surgery (CABG) - Indications, LOS; Extracranial-Intracranial arterial bypass surgery; heart volume reduction surgery;

- Radiology benefit Management: Web practical information on radiology, nuclear medicine and radiation therapy provider manuals.

Intrahepatic Chemotherapy pertaining to Liver metastasis - Chemoembolization; Isolated limb perfusion (ILP); Mitoxantrone hydrochloride (Novantrone (R)); Monoclonal Antibody (Mab) Imaging or perhaps Radioimmunoscintigraphy - colorectal cancer staging; Photodynamic Therapy; Radiofrequency tumor ablation; Therapeutic phlebotomy; Vaccines to end up being able to treat various cancers; Cancer-related web sites; Photodynamic Therapy; Vaccines for you to treat numerous cancers; Vitamin B12 Injections.

Environmental control Systems; Vaporizers; Physical exercise Equipment; Hearing aids; Bone-anchored Hearing Aid; Hospital beds, Infusion pumps, external as well as implantable; Intrapulmonary Percussive Ventilator (IPV); Jobst burn Garments;

- Introduction: Introduction to be able to referral authorization management guidelines and also criteria; CMS national policies; levels associated with risk inside capitation; basic elements of a utilization management plan; Consultants vs

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