ARCHIVED Interventional Pain Management 2021-11-07 to 2022-03-12
CLINICAL APPROPRIATENESS GUIDELINES Musculoskeletal Program Appropriate Use Criteria: Interventional Pain Management EFFECTIVE NOVEMBER 7, 2021 ARCHIVED MARCH 13, 2022 This document has been archived because it has outdated information. It is for historical...ARCHIVED Implantable Cardioverter Defibrillators 2021-01-01 to 2021-11-06
ARCHIVED Cardiac Resynchronization Therapy 2021-01-01 to 2021-11-06
ARCHIVED Spine Surgery 2021-11-07 to 2021-12-31
20930, 20931, 20932, 20933, 20934, 20936, 20937, 20938, 20939, 20974, 22206, 22207, 22208, 22210, 22212, 22214, 22216, 22220, 22222, 22224, 22226, 22510, 22511, 22512, 22513, 22514, 22515, 22532, 22533, 22534, 22548, 22551, 22552, 22554, 22556, 22558, 22585, 22590, 22595, 22600, 22610, 22612, 22614, 22630, 22632, 22633, 22634, 22800, 22802, 22804, 22808, 22810, 22812, 22818, 22819, 22830, 22840, 22841, 22842, 22843, 22844, 22845, 22846, 22847, 22848, 22849, 22853, 22854, 22856, 22857, 22858, 22859, 22861, 22862, 22864, 22865, 63001, 63003, 63005, 63012, 63015, 63016, 63017, 63020, 63030, 63035, 63040, 63042, 63043, 63044, 63045, 63046, 63047, 63048, 63050, 63051, 63055, 63056, 63057, 63075, 63076, 63081, 63082, 63085, 63086, 63087, 63088, 63090, 63091, 63101, 63102, 63103, 63185, 63190, 63191, 63194, 63196, 63198, 63200, 63250, 63252, 63265, 63267, 63270, 63272, 63275, 63277, 63280, 63282, 63285, 63287, 63290, 63300, 63301, 63302, 63303, 63304, 63305, 63306, 63307, 63308, 0095T, 0098T, 0163T , 0164T , 0165T , 0200T, 0201T, C9359, C9362, C9757, E0748