ARCHIVED Implantable Cardioverter Defibrillators 2021-11-07 to 2023-09-09
Archive Date: 09/10/2023 This document has been archived because it has outdated information. It is for historical information only and should not be consulted for clinical use. Current versions of guidelines are available on the Carelon Medical Benefits Management...ARCHIVED Sacroiliac Joint Fusion 2021-09-12 to 2023-03-31 for Indiana Medicaid
CLICK HERE TO ACCESS PDF VERSION Archive Date: 04/01/2023 for Indiana Medicaid This document has been archived because it has outdated information. It is for historical information only and should not be consulted for clinical use. Current versions of guidelines are...ARCHIVED Joint Surgery 2021-09-12 to 2023-11-04 for Indiana Medicaid
Link to PDF Archive Date: 11/05/2023 This document has been archived because it has outdated information. It is for historical information only and should not be consulted for clinical use. Current versions of guidelines are available on the Carelon Medical...ARCHIVED Imaging of the Spine 2021-09-12 to 2023-03-31 for Indiana Medicaid
72125, 72126, 72127, 72128, 72129, 72130, 72131, 72132, 72133, 72141, 72142, 72146, 72147, 72148, 72149, 72156, 72157, 72158, 77078, 78811, 78812, 78813, 78814, 78815, 78816, G0235, S8085