ACG-Marshfield Clinic Demonstration Project
72 Hour Continuous Glucose Monitoring (CGM) Systems In Office
Abdominoplasty & Panniculectomy
Abnormal Vascular Lesion Removal
Ambulance: Land and Air Transportation
Autologous Cultured Chondrocytes
Back Surgical Procedures: Cervical & Thoracic Spinal Levels Inpatient & Outpatient
Back Surgical Procedures: Lumbar Spinal Level
Inpatient & Outpatient
Back Surgical Procedure Vertebroplasty Inpatient & Outpatient
Blepharoplasty, Blepharoptosis Repair
Bone & Tendon Graft Substitutes & Adjuncts
Bone Growth Stimulator for the 5th Metatarsal
Botulinum Toxin Injections
Breast Reconstruction Post Mastectomy
Breast Reduction Mammoplasty
Carpal Tunnel Repair Surgical Precerti-fication
Carpal Tunnel Syndrome-Median Neuropathy Specialty Consult
Cellular Therapies
Chelation Therapy
Chronic Hip Pain-Osteoarthritis Specialty Consult
Chronic Knee Pain-Osteoarthritis or Meniscal Degeneration Specialty Consult
Cluster & Migraine Headache: Nonsurgical Management
Cologuard DNA Stool Testing
Complementary & Alternative Medicine
Contact Lenses
& Other Eyewear
Core Decompression of AVN of the Femoral Head
Cosmetic Surgery/Treatments
Cryoablation
Electrical Stimulation & Electromagnetic Therapy for the Treatment of Wounds
Electro-convulsive Therapy
Electroenceph-alography EEG Procedures
Erectile Dysfunction Treatments
Experimental
or Investigational
Eye Movement Desensitization &
Reprocessing (EMDR)
Fecal Microbiota Transplantation FMT
Femoroace-tabular Surgery for Hip Impingement Syndrome
Gastric Pacing & Gastric Electrical Stimulation
Gender Reassignment Services & Surgical Procedures
Genetic
Testing
Home Care Coverage Criteria
Home Health Care- Medicare Advantage
Home
Infusion
Hospice
Health
Services
Hyperbaric Oxygen Therapy
Hyperthermic Intraperitoneal Chemotherapy
Hysterectomy Surgical Procedures
Implantable Cardioverter Defibrillator ICD Insertion Procedures
Implantable Hormone Pellet Replacement Therapy
Implantable Loop Recorder
Infuse Bone Graft Bmp-2 Procedure
Inpatient Admission Prior to Surgery
(Pre-op)
Intrastromal Corneal Ring Segments
Ivor Lewis Procedure
Knee Arthroscopy Surgery Precertification
Left Atrial Appendage (LAA) Closure to Reduce the Risk of Stroke
Lipectomy or Suction Assisted Lipectomy
Low Back Pain (LBP) Consultation with Orthopedic or Neurosurgical Specialist
Lung Volume Reduction Surgery
MAZE
Procedure
Medicare Advantage Chiropractor
Medicare Advantage Skilled Nursing Facility Coverage Criteria
Medtronic IN.PACT Admiral Paclitaxel-coated PTA Balloon
Mitraclip Procedure
Obesity Management, Surgical Approaches
Oral Appliances for the Treatment of Obstructive Sleep Apnea
Outpatient & Inpatient Chemotherapy Administration
Pancreas Transplant Alone (PTA) and Autologous Islet Cell Transplants
Peripheral Vascular
Stents
Physical, Occupational & Speech Therapy
Private Duty Nursing in the Home Setting
Radiesse
Radiofrequency Ablation Pulmonary Tumor Debulking
Refractive Eye Surgery
Septoplasty/Rhinoplasty
Skin Substitutes, Chemical Peels, Dermabrasions, & other Skin Procedures
Sleep
Studies
Spinal Cord Stimulation
Swing
Bed
Synagis Injections
Telehealth
TMJ Benefit Review
Tilt Table Testing
Total Ankle Replacement
Total Disc Arthroplasty
Total Hip Replacement Surgical Precertification
Total Knee Replacement Surgical Precertification
Transcatheter Aortic Valve Replacement (TAVR)
Treatment of Autism Spectrum Disorders
Treatment of Chronic Skin Conditions
Urinary Incontinence
Vagus Nerve Stimulation for Epilepsy & Depression
™