AvMed Coverage Guidelines

AvMed Health Plans uses various tools, including Coverage Issues Guidelines, to assist in interpreting plan coverage provisions.  As medical technology is continuously changing, our Coverage Issues Guidelines are subject to change without prior notice, or may be withdrawn from use.

• Abdominoplasty & Panniculectomy
• Acoustic_Rhinometry
• Alopecia Areata Treatment
• Atrial Appendage Closure
• Attention DeficitHyperactivity Disorder (ADHD) Treatment
• Autism Spectrum Disorder, Diagnosis, & Treatment Guidelines
• Autologous Chondrocyte Implantation
• Axial Lumbar Interbody Fusion (AxiaLif)
• Benign Lesion Removal Coverage Guidelines
• Blepharoplasty & Brow Ptosis Repair
• Bone Growth Stimulator Coverage Guidelines
• BRCA 1, BRCA 2 Genetic Testing
• Cane, Crutches, & Walker Coverage Guidelines
• Cardiac Signal Analysis Procedures
• Chelation Therapy
• Chronic Cerebro-Spinal Venous Insufficiency
• Chronic Intermittent Intravenous Insulin Therapy
• Cochlear Implant, Bone Anchored Hearing Aids, and Auditory Brainstem Implant
• Computerized Gait Analysis
• Continuous Subcutaneous Insulin Infusion Pump
• Cosmetic Surgery & Procedures Coverage Guidelines
• Cranial Sacral Therapy Guidelines
• Dupuytrens Contracture
• Electromagnetic Navigation Guided Bronchoscopy
• EMS for Urinary Incontinence
• Endo-PAT 2000
• EndoCinch
• Enteral Nutrition
• EsophyX
• Gastric Surgery for Clinically Severe (Morbid) Obesity
• Guidelines for Implantable Infusion Pumps, Spinal Cord Stimulators & Neuromuscular Stimulators
• High Frequency Chest Wall Oscillation
• Hyperbaric Oxygen Therapy for Wound Care Treatment
• Implantable Hormone Pellets
• In Utero Fetal Surgery
• INTACS
• Interventional Pain Management Clinical Coordination Criteria
• Intradiscal Electrothermal Therapy
• MRI-Guided Focused Ultrasound Treatment of Fibroids
• Myo-electric Microprocessor Controlled Upper & Lower Prostheses
• Negative Pressure Wound Therapy
• Neonates with Nitric Oxide or ECMO
• Neuromonics Tinnitus Treatment
• Neuropsychological Testing Coverage Guidelines
• Neurostim in Resistant Depression
• Oxygen Therapy Coverage Guidelines for non-Medicare Advantage Members
• Pectus Deformity Repair
• Phototherapy and Photochemotherapy Treatment (Ultraviolet A [PUVA] and B [UBV])
• Platelet Rich Plasma and Fibrin Matrix
• Preventive Care for Commercial Members
• Prophylactic Mastectomy
• Proton Beam Radiation Therapy
• PT or INP Monitoring at Home
• Pyrocarbon Metac Prox Interphal Joint Implants
• Real Time Cont Glucose Monitoring
• Reduction Mammaplasty (Mammoplasty) Coverage Guidelines for Female Members
• Robotic Surgery
• Sinus Balloon Inflation Device
• Skin Substitutes for Wound Care
• Sleep Study Coverage Guidelines Including Split-study Parameters and CPAPBiPAP
• Spinal Manipulation Under Anesthesia
• Spinal Unloading Devices
• Stretta
• Thermal Capsulorrhapy
• TMS for Major Depression
• Total Ankle Arthroplasty
• Ultrasonic Treatment of Plantar Fasciitis
• Ventricular Assist Devices (VAD)
• Virtual Colonoscopy
• Wheelchair Coverage Guidelines