Medicaid Managed Care Policies & Procedures Archive (2023) - Continued page 2

"Policy or procedure" shall mean a requirement governing the administration of managed care organizations specific to billing guidelines, medical management and utilization review guidelines, case management guidelines, claims processing guidelines and edits, grievance and appeals procedures and process, other guidelines or manuals containing pertinent information related to operations and pre-processing claims, and core benefits and services.

Below are items previously posted for public comment:

Item Number Policy/Procedure Date Posted Comment Period Closed Status Document Links
2023-HBL-1102 Allogen, Xeno, Synthc and Composite Products for Wound Healing and Soft Tissue Grafting 9/12/23 10/27/23 Approved Allogen, Xeno, Synthc and Composite Products for Wound Healing and Soft Tissue Grafting
2023-HBL-1201 Vena Cava Filters 9/12/23 10/27/23 Approved Vena Cava Filters
2023-LHCC-1211 Reduction Mammoplasty and Gynecomastia Surgery 9/12/23 10/27/23 Approved Reduction Mammoplasty and Gynecomastia Surgery
2023-LHCC-1224 Fetal Surgery in Utero 9/12/23 10/27/23 Approved Fetal Surgery in Utero
2023-HBL-1238 Upper Gastrointestinal Endoscopy in Adults 9/12/23 10/27/23 Approved Upper Gastrointestinal Endoscopy in Adults
2023-HBL-1346 Virtual Reality-Assisted Therapy Systems 9/12/23 10/27/23 Approved Virtual Reality-Assisted Therapy Systems
2023-LHCC-1452 Caudal or Interlaminar Epidural Steroid Injections 9/12/23 10/27/23 Approved Caudal or Interlaminar Epidural Steroid Injections
2023-LHCC-1454 Facet Joint Interventions 9/12/23 10/27/23 Approved Facet Joint Interventions
2023-LHCC-1456 Fecal Incontinence Treatments 9/12/23 10/27/23 Approved Fecal Incontinence Treatments
2023-LHCC-1457 Neuromuscular Electrical Stimulation 9/12/23 10/27/23 Approved Neuromuscular Electrical Stimulation
2023-LHCC-1504 Reporting the Global Maternity Package 9/12/23 10/27/23 Approved Reporting the Global Maternity Package
2023-LHCC-1712 Transportation for SDOH 9/12/23 10/27/23 Approved Transportation for SDOH
2023-LHCC-1743 Hospice Services 9/12/23 10/27/23 Approved Hospice Services
2023-LHCC-1746 Total Artificial Heart 9/12/23 10/27/23 Approved Total Artificial Heart
2023-LHCC-1840 Cochlear Implants and Replacements 9/12/23 10/27/23 Approved Cochlear Implants and Replacements
2023-UHC-1939 Beds and Mattresses 9/12/23 10/27/23 Approved Beds and Mattresses
2023-HUM-2173 Genetic Testing 9/12/23 10/27/23 Approved Genetic Testing
2023-HUM-2180 Homebuilders 9/12/23 10/27/23 Approved Homebuilders
2023-HBL-2181 Prior Authorization Changes UM AROW 3959 9/12/23 10/27/23 Approved Prior Authorization Changes UM AROW 3959
2023-HBL-2182 Prior Authorization Changes UM AROW 4073 9/12/23 10/27/23 Approved Prior Authorization Changes UM AROW 4073
2023-HBL-2185 Technology Assisted Surgery Procedures 9/12/23 10/27/23 Approved Technology Assisted Surgery Procedures
2023-HBL-2191 Digital Therapy Devices for Treatment of Amblyopia 9/12/23 10/27/23 Approved Digital Therapy Devices for Treatment of Amblyopia
2023-ACLA-2200 Psychiatric Residential Treatment 9/12/23 10/27/23 Approved Psychiatric Residential Treatment
2023-ACLA-2202 Crisis Stabilization – Adults 9/12/23 10/27/23 Approved Crisis Stabilization – Adults
2023-ACLA-2203 Crisis Stabilization – Pediatrics 9/12/23 10/27/23 Approved Crisis Stabilization – Pediatrics
2023-ACLA-2204 Infertility Diagnosis and Treatment 9/12/23 10/27/23 Approved Infertility Diagnosis and Treatment
2023-HBL-2214 Diagnostic Fibrotic Flexible Laryngoscopy 9/12/23 10/27/23 Approved Diagnostic Fibrotic Flexible Laryngoscopy
2023-LDH-14 MCO Manual > Part 9: Provider Network > Primary Care > Enrollee Reassignment Policy (Effective date = 11/15/2023) 8/25/23 10/9/23 Pending Enrollee Reassignment Policy
2023-LHCC-1471 24 Hour Payment Rule 8/25/23 10/9/23 Approved 24 Hour Payment Rule
2023-LHCC-1496 Hospital Visit Codes Billed with Labs 8/25/23 10/9/23 Approved Hospital Visit Codes Billed with Labs
2023-LHCC-1503 Inpatient Only Procedures 8/25/23 10/9/23 Approved Inpatient Only Procedures
2023-UHC-1523 Facet Joint and Medial Branch Block Injections for Spinal Pain 8/25/23 10/9/23 Approved Facet Joint and Medial Branch Block Injections for Spinal Pain
2023-LHCC-1833 Assertive Community Treatment (ACT) 8/25/23 10/9/23 Approved Assertive Community Treatment (ACT)
2023-ABH-1943 Member Incentives 8/25/23 10/9/23 Approved Member Incentives
2023-LHCC-2184 Organizational Assessment and Reassessment 8/25/23 10/9/23 Complete Organizational Assessment and Reassessment
2023-UHC-2186 Left Atrial Appendage Closure 8/25/23 10/9/23 Approved Left Atrial Appendage Closure
2023-HBL-2187 Level of Care for Musculoskeletal Surgery and Procedures 8/25/23 10/9/23 Approved Level of Care for Musculoskeletal Surgery and Procedures
2023-UHC-2188 Mandatory Medicaid Coverage of Routine Patient Costs in  Qualifying Clinical Trials 8/25/23 10/9/23 Approved Mandatory Medicaid Coverage of Routine Patient Costs in  Qualifying Clinical Trials
2023-HBL-2189 Ultrasound Bone Growth Stimulation 8/25/23 10/9/23 Approved Ultrasound Bone Growth Stimulation
2023-HBL-2190 Myringotomy and Tympsnodtomy Tube Insertion 8/25/23 10/9/23 Approved Myringotomy and Tympsnodtomy Tube Insertion
2023-HBL-2192 Magnetic Source Imaging and Magnetoencephalography 8/25/23 10/9/23 Approved Magnetic Source Imaging and Magnetoencephalography
2023-HBL-2193 Vertical Prosthetic Titanium 8/25/23 10/9/23 Approved Vertical Prosthetic Titanium
2023-HBL-2194 Surgical Treatment for Dupuytren's Contracture 8/25/23 10/9/23 Approved Surgical Treatment for Dupuytren's Contracture
2023-HBL-2195 Prostate Specific Antigen Testing 8/25/23 10/9/23 Approved Prostate Specific Antigen Testing
2023-HBL-2196 Intraocular Anterior Segment Aqueous Drainage Devices (without extraocular reservoirs) 8/25/23 10/9/23 Approved Intraocular Anterior Segment Aqueous Drainage Devices (without extraocular reservoirs)
2023-HBL-2197 Auditory Brainstem Response (ABR) and Evoked Emissions 8/25/23 10/9/23 Approved Auditory Brainstem Response (ABR) and Evoked Emissions
2023-HBL-2198 Diagnostic Hysteroscopy for Infertility 8/25/23 10/9/23 Approved Diagnostic Hysteroscopy for Infertility
2023-UHC-379 Brow Ptosis and Eyelid Repair 8/25/23 10/9/23 Approved Brow Ptosis and Eyelid Repair
2023-UHC-492 Surgical and Ablative Procedures for Venous Insufficiency and Varicose Veins 8/25/23 10/9/23 Approved Surgical and Ablative Procedures for Venous Insufficiency and Varicose Veins
2023-UHC-509 Breast Reconstruction 8/25/23 10/9/23 Approved Breast Reconstruction
2023-UHC-558 Surgery of the Knee 8/25/23 10/9/23 Approved Surgery of the Knee
2023-UHC-561 Cognitive Rehabilitation 8/25/23 10/9/23 Approved Cognitive Rehabilitation
2023-HBL-985 Small Joint Surgery Criteria 8/25/23 10/9/23 Approved Small Joint Surgery Criteria
2023-HBL-1023 Genetic Testing for Inherited Diseases 8/25/23 10/9/23 Approved Genetic Testing for Inherited Diseases
2023-HBL-1026 Gene Expression Profiling for Managing Breast Cancer Treatment 8/25/23 10/9/23 Approved Gene Expression Profiling for Managing Breast Cancer Treatment
2023-HBL-1042 Ablative Techniques as a Treatment for Barrett's Esophagus 8/25/23 10/9/23 Approved Ablative Techniques as a Treatment for Barrett's Esophagus
2023-HBL-1091 Transcatheter Heart Valve Procedures 8/25/23 10/9/23 Approved Transcatheter Heart Valve Procedures
2023-HBL-1123 Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions and Soft Tissue Wounds 8/25/23 10/9/23 Approved Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions and Soft Tissue Wounds
2023-HBL-1203 CMA for Developmental Delay 8/25/23 10/9/23 Approved CMA for Developmental Delay
2023-HBL-1221 Diagnostic Infertility Surgery 8/25/23 10/9/23 Approved Diagnostic Infertility Surgery
2023-HBL-1260 Circulating Tumor DNA Panel Testing (Liquid Biopsy) 8/25/23 10/9/23 Approved Circulating Tumor DNA Panel Testing (Liquid Biopsy)
2023-HBL-1309 BRCA Genetic Testing 8/25/23 10/9/23 Approved BRCA Genetic Testing
2023-HBL-1320 Joint Surgery 8/25/23 10/9/23 Approved Joint Surgery
2023-HBL-1323 Hyperbaric Oxygen Therapy 8/25/23 10/9/23 Approved Hyperbaric Oxygen Therapy
2023-UHC-1426 Genetic Testing for Cardiac Disease 8/25/23 10/9/23 Approved Genetic Testing for Cardiac Disease
2023-HBL-1463 Nucleic Acid Amplification Tests Using Algorithmic Analysis for the Diagnosis of Bacterial Vaginosis 8/25/23 10/9/23 Approved Nucleic Acid Amplification Tests Using Algorithmic Analysis for the Diagnosis of Bacterial Vaginosis
2023-UHC-559 Implantable Beta-Emitting Microspheres 8/8/23 9/22/23 Approved Implantable Beta-Emitting Microspheres
2023-LHCC-1479 High Complexity Medical Decision-Making 8/8/23 9/22/23 Approved High Complexity Medical Decision-Making
2023-LHCC-1500 Pulse Oximetry with Office Visits 8/8/23 9/22/23 Approved Pulse Oximetry with Office Visits
2023-LHCC-1701 Outpatient Testing for DOA (Drugs of Use) 8/8/23 9/22/23 Approved Outpatient Testing for DOA (Drugs of Use)
2023-LHCC-1705 Invasive and Non-Invasive Home Ventilator 8/8/23 9/22/23 Approved Invasive and Non-Invasive Home Ventilator
2023-ACLA-1870 Behavioral Health Crisis Care 8/8/23 9/22/23 Approved Behavioral Health Crisis Care
2023-LHCC-1908 Community Brief Crisis Support 8/8/23 9/22/23 Approved Community Brief Crisis Support
2023-UHC-1941 Louisiana ABA Policy 8/8/23 9/22/23 Approved Louisiana ABA Policy
2023-HUM-2161 Intrauterine Device 8/8/23 9/22/23 Approved Intrauterine Device
2023-HUM-2162 Nexplanon, Etonogestrel Implant 8/8/23 9/22/23 Approved Nexplanon, Etonogestrel Implant
2023-HUM-2167 Duplicate Diagnosis 8/8/23 9/22/23 Approved Duplicate Diagnosis
2023-HUM-2168 Intrauterine Contraceptive Systems and Implants 8/8/23 9/22/23 Approved Intrauterine Contraceptive Systems and Implants
2023-HUM-2169 Assistant Surgeon Modifiers 8/8/23 9/22/23 Approved Assistant Surgeon Modifiers
2023-HUM-2174 Levonorgestrl-releasing intrauterine contraceptive 8/8/23 9/22/23 Approved Levonorgestrl-releasing intrauterine contraceptive
2023-HUM-2177 Nexplanon 8/8/23 9/22/23 Approved Nexplanon
2023-LDH-13 State Directed Payment Program Manual 8/2/23 9/16/23 Pending State Directed Payment Program Manual
2023-LDH-12 MCO Manual > Part 4: Services > Medical Transportation (Proposed effective date = 10/23/2023) 8/2/23 9/16/23 Pending Medical Transportation
2023-HBL-819 HBL Provider Manual 8/25/23 10/9/23 Withdrawn HBL Provider Manual
2023-LHCC-1491 NCCI Unbundling 7/27/23 9/10/23 Complete NCCI Unbundling
2023-LHCC-1494 Assistant Surgeon 7/27/23 9/10/23 Complete Assistant Surgeon
2023-LHCC-1497 Modifier to Procedure Code Validation 7/27/23 9/10/23 Complete Modifier to Procedure Code Validation
2023-LHCC-1501 Distinct Procedural Modifiers 7/27/23 9/10/23 Complete Distinct Procedural Modifiers
2023-LHCC-1502 Professional Services Billed with Labs 7/27/23 9/10/23 Complete Professional Services Billed with Labs
2023-LHCC-1505 Moderate Conscious Sedation 7/27/23 9/10/23 Complete Moderate Conscious Sedation
2023-LHCC-1507 Clinical Validation of Modifier 59 7/27/23 9/10/23 Complete Clinical Validation of Modifier 59
2023-LHCC-1508 Intravenous Hydration 7/27/23 9/10/23 Complete Intravenous Hydration
2023-LHCC-1509 Clinical Validation of Modifier 25 7/27/23 9/10/23 Complete Clinical Validation of Modifier 25
2023-LHCC-1510 EM Bundling with Labs and Radiology 7/27/23 9/10/23 Complete EM Bundling with Labs and Radiology
2023-LHCC-1213 Sacroiliac Joint Fusion 7/26/23 9/10/23 Approved Sacroiliac Joint Fusion
2023-LHCC-1270 Urinary Incontinence Devices and Treatments 7/26/23 9/10/23 Approved Urinary Incontinence Devices and Treatments
2023-LHCC-1272 PCR Respiratory Viral Panel Testing 7/26/23 9/10/23 Approved PCR Respiratory Viral Panel Testing
2023-LHCC-1388 Code Editing Overview 7/26/23 9/10/23 Complete Code Editing Overview
2023-LHCC-1412 Clinical Trials 7/26/23 9/10/23 Approved Clinical Trials
2023-LHCC-1413 Discography 7/26/23 9/10/23 Approved Discography
2023-LHCC-1472 Transparency Policy: Place of Service Mismatch 7/26/23 9/10/23 Complete Transparency Policy: Place of Service Mismatch
2023-LHCC-1487 Sleep Studies Place of Service 7/26/23 9/10/23 Complete Sleep Studies Place of Service
2023-LHCC-1495 Add-on Code Billed without Primary Code 7/26/23 9/10/23 Complete Add-on Code Billed without Primary Code
2023-LHCC-1498 Professional Component Modifier 7/26/23 9/10/23 Complete Professional Component Modifier
2023-LHCC-1499 Clean Claims Policy 7/26/23 9/10/23 Complete Clean Claims Policy
2023-LHCC-1506 Never Paid Events 7/26/23 9/10/23 Complete Never Paid Events
2023-LHCC-1511 Unlisted Procedure Codes 7/26/23 9/10/23 Complete Unlisted Procedure Codes
2023-LHCC-1512 Maximum Units of Service 7/26/23 9/10/23 Complete Maximum Units of Service
2023-ACLA-1937 ILOS - Hospital Based Care Coordination 7/26/23 9/10/23 Approved ILOS - Hospital Based Care Coordination
2023-ACLA-1942 Duplicate Claim 7/26/23 9/10/23 Approved Duplicate Claim
2023-LHCC-2178 Omisirge (Omidubicel) 7/26/23 9/10/23 Approved Omisirge (Omidubicel)
2023-LHCC-2179 Rapid Whole Genome Sequencing of Critically Ill Infants 7/26/23 9/10/23 Approved Rapid Whole Genome Sequencing of Critically Ill Infants
2023-LDH-11 MCO Manual > Part 4: Services > Pharmacy > Prior Authorization (Proposed effective date = 10/16/2023) 7/26/23 9/9/23 Approved Pharmacy Prior Authorization
2023-UHC-222 Skin and Soft Tissue Substitutes 7/26/23 9/9/23 Approved Skin and Soft Tissue Substitutes
2023-UHC-476 Cytological Examination of Breast Fluids for Cancer Screening or Diagnosis 7/26/23 9/9/23 Approved Cytological Examination of Breast Fluids for Cancer Screening or Diagnosis
2023-UHC-582 Cosmetic and Reconstructive Procedures 7/26/23 9/9/23 Approved Cosmetic and Reconstructive Procedures
2023-UHC-794 Noncontact Warming Therapy, Ultrasound therapy and Fluorescence Imaging for Wounds 7/26/23 9/9/23 Approved Noncontact Warming Therapy, Ultrasound therapy and Fluorescence Imaging for Wounds
2023-LHCC-934 BH Provider Quality Program 7/26/23 9/9/23 Approved BH Provider Quality Program
2023-ABH-1007 BH Provider Monitoring Strategy 7/26/23 9/9/23 Approved BH Provider Monitoring Strategy
2023-HBL-1319 Imaging of the Extremities 7/26/23 9/9/23 Approved Imaging of the Extremities
2023-HBL-1321 Vascular Imaging 7/26/23 9/9/23 Approved Vascular Imaging
2023-HBL-1322 Imaging of the Spine 7/26/23 9/9/23 Approved Imaging of the Spine
2023-HBL-1325 Sleep Disorder Management 7/26/23 9/9/23 Approved Sleep Disorder Management
2023-UHC-1404 Breast Imaging for Screening and Diagnosing Cancer 7/26/23 9/9/23 Approved Breast Imaging for Screening and Diagnosing Cancer
2023-UHC-1419 Carrier Testing for Genetic Diseases 7/26/23 9/9/23 Approved Carrier Testing for Genetic Diseases
2023-HBL-1749 Gene Therapy for Hemophilia 7/26/23 9/9/23 Approved Gene Therapy for Hemophilia
2023-ACLA-1867 Psychosocial Rehabilitation Services for Children, Adolescents and Adults 7/26/23 9/9/23 Approved Psychosocial Rehabilitation Services for Children, Adolescents and Adults
2023-LHCC-1947 ADHD 7/26/23 9/9/23 Approved ADHD
2023-LHCC-1959 BH Treatment Documentation Requirements 7/26/23 9/9/23 Approved BH Treatment Documentation Requirements
2023-Humana-2163 Etonogestrel (contraceptive) implant system 7/26/23 9/9/23 Approved Etonogestrel (contraceptive) implant system
2023-LDH-10 MCO Manual > Part 4: Services > Professional Services > Telemedicine/Telehealth (Proposed effective date = 10/11/2023) 7/21/23 9/3/23 Pending Telemedicine/Telehealth
2023-LDH-9 MCO Manual > Part 4: Services > Hospital Services > General Policies > Inpatient vs. Outpatient Services (Proposed effective date = 10/11/2023) 7/21/23 9/3/23 Pending Inpatient vs. Outpatient Services
2023-HBL-2158 Human Chorionic Gonadotrophin Testing 7/17/23  8/31/23 Approved Human Chorionic Gonadotrophin Testing
2023-HBL-2157 Outpatient Alpha-Fetoprotein Testing 7/17/23  8/31/23 Approved Outpatient Alpha-Fetoprotein Testing 
2023-HBL-2156 Balloon Dilation of the Eustachian Tubes 7/17/23 8/31/23 Approved Balloon Dilation of the Eustachian Tubes
2023-LHCC-2153 Pharmacy Lock-In Program 7/17/23 8/31/23  Complete Pharmacy Lock-In Program
2023-ACLA-2137 Continuous Glucose Monitoring 7/17/23 8/31/23 Approved Continuous Glucose Monitoring
2023-ACLA-1989 Sleep Apnea Treatment Program Exclusions 7/17/23 8/31/23 Approved Sleep Apnea Treatment Program Exclusions
2023-ACLA-1981 Stimulators - Non-Spinal Electrical Osteogenesis Stimulator 7/17/23 8/31/23 Approved Stimulators - Non-Spinal Electrical Osteogenesis Stimulator
2023-LHCC-1938 Continuity & Coordination Between Medical and Behavioral Health Care 7/17/23 8/31/23 Approved Continuity & Coordination Between Medical and Behavioral Health Care
2023-HBL-1783 Mechanical Embolectomy for Treatment of Stroke 7/17/23 8/31/23 Approved Mechanical Embolectomy for Treatment of Stroke
2023-HBL-1303 Thyroid Testing 7/17/23 8/31/23 Approved Thyroid Testing
2023-HBL-1061 Venous Angioplasty with or without Stent Placement or Venous Stent Alone 7/17/23 8/31/23 Approved Venous Angioplasty with or without Stent Placement or Venous Stent Alone
2023-LHCC-896 Physician Incentive Plan 7/17/23 8/31/23 Approved Physician Incentive Plan
2023-ACLA-2133 DME Prior Authorization Revisions (982 codes) 7/7/23 8/21/23 Approved DME Prior Authorization Revisions (982 codes)
2023-ACLA-2133 Professional Services Prior Authorization Revisions (678 codes) 7/7/23 8/21/23 Approved Professional Services Prior Authorization Revisions (678 codes)
2023-ACLA-2142 Genetic Testing for Carrier Status 7/5/23 8/19/23 Approved Genetic Testing for Carrier Status
2023-ACLA-2143 Genetic Testing for Known Familial Mutations 7/5/23 8/19/23 Approved Genetic Testing for Known Familial Mutations
2023-ACLA-2144 Genetic Testing for Non-Medical Purposes 7/5/23 8/19/23 Approved Genetic Testing for Non-Medical Purposes
2023-ACLA-2145 Genetic Testing for Variants of Uncertain Clinical Significance 7/5/23 8/19/23 Approved Genetic Testing for Variants of Uncertain Clinical Significance
2023-ACLA-2146 Genetic Testing for Prenatal Screening and Diagnostic Testing 7/5/23 8/19/23 Approved Genetic Testing for Prenatal Screening and Diagnostic Testing
2023-ACLA-2147 Genetic Testing for the Screening, Diagnosis, and Monitoring of Cancer 7/5/23 8/19/23 Approved Genetic Testing for the Screening, Diagnosis, and Monitoring of Cancer
2023-ACLA-2148 Genetic Testing to Diagnose Non-Cancer Conditions 7/5/23 8/19/23 Approved Genetic Testing to Diagnose Non-Cancer Conditions
2023-ACLA-2149 Genetic Testing to Predict Disease Risk 7/5/23 8/19/23 Approved Genetic Testing to Predict Disease Risk
2023-ACLA-2150 Hereditary (Germline) Testing After Tumor (Somatic) Testing 7/5/23 8/19/23 Approved Hereditary (Germline) Testing After Tumor (Somatic) Testing
2023-ACLA-2151 Investigational and Experimental laboratory Testing 7/5/23 8/19/23 Approved Investigational and Experimental laboratory Testing
2023-ACLA-2152 Pharmacogenomic Testing for Drug Toxicity and Response 7/5/23 8/19/23 Approved Pharmacogenomic Testing for Drug Toxicity and Response
2023-LHCC-1167 DME Clinical Policy 7/5/23 8/19/23 Approved DME Clinical Policy
2023-LHCC-1218 Ventricular Assist Devices 7/5/23 8/19/23 Approved Ventricular Assist Devices
2023-HBL-1301 Sacroiliac Joint Fusion 7/5/23 8/19/23 Approved Sacroiliac Joint Fusion
2023-HBL-1324 Spine Surgery 7/5/23 8/19/23 Approved Spine Surgery
2023-LHCC-1357 Intestinal and Multivisceral Transplant 7/5/23 8/19/23 Approved Intestinal and Multivisceral Transplant
2023-ACLA-1370 EPSDT PCS 1511-04 7/5/23 8/19/23 Approved EPSDT PCS 1511-04
2023-LHCC-1382 Lysis of Epidural Lesions 7/5/23 8/19/23 Approved Lysis of Epidural Lesions
2023-LHCC-1383 Disc Decompression Procedures 7/5/23 8/19/23 Approved Disc Decompression Procedures
2023-LHCC-1387 Percutaneous LAAD Stroke Prevention 7/5/23 8/19/23 Approved Percutaneous LAAD Stroke Prevention
2023-LHCC-1917 Repair of Nasal Valve Compromise 7/5/23 8/19/23 Approved Repair of Nasal Valve Compromise
2023-ACLA-1984 Oral Appliances for the Treatment of OSA 7/5/23 8/19/23 Approved Oral Appliances for the Treatment of OSA
2023-ACLA-1998 Neurological Considerations 7/5/23 8/19/23 Approved Neurological Considerations
2023-ACLA-2132 Spinal Muscular Atrophy Testing 7/5/23 8/19/23 Approved Spinal Muscular Atrophy Testing
2023-ACLA-2134 Sleep Disordered Breathing Diagnosis and Treatment, Diagnostic Testing Pre- and Post-Hypoglossal nerve Stimulator Implantation 7/5/23 8/19/23 Approved Sleep Disordered Breathing Diagnosis and Treatment, Diagnostic Testing Pre- and Post-Hypoglossal nerve Stimulator Implantation
2023-ACLA-2135 Ataxia-Telangiectasia Genetic Testing 7/5/23 8/19/23 Approved Ataxia-Telangiectasia Genetic Testing
2023-ACLA-2136 Polymerase Gamma (POLG) Related Disorders Genetic Testing 7/5/23 8/19/23 Approved Polymerase Gamma (POLG) Related Disorders Genetic Testing
2023-ACLA-2138 Confirmatory Genetic Testing 7/5/23 8/19/23 Approved Confirmatory Genetic Testing
2023-ACLA-2139 Genetic Presymptomatic and Predictive Testing for Adult-Onset conditional in Minors 7/5/23 8/19/23 Approved Genetic Presymptomatic and Predictive Testing for Adult-Onset conditional in Minors
2023-ACLA-2140 Genetic Testing by Multigene Panels 7/5/23 8/19/23 Approved Genetic Testing by Multigene Panels
2023-ACLA-2141 Genetic Testing for Cancer susceptibility and Hereditary Cancer syndromes 7/5/23 8/19/23 Approved Genetic Testing for Cancer susceptibility and Hereditary Cancer syndromes
2023-ACLA-2112 Oncotype DX Breast DCIS 6/29/23 8/13/23 Approved Oncotype DX Breast DCIS
2023-ACLA-2113 Oncotype DX for Breast Cancer Prognosis 6/29/23 8/13/23 Approved Oncotype DX for Breast Cancer Prognosis
2023-ACLA-2114 Oncotype DX for Colorectal Cancer Recurrence risk 6/29/23 8/13/23 Approved Oncotype DX for Colorectal Cancer Recurrence risk
2023-ACLA-2115 Oncotype DX for Prostate Cancer 6/29/23 8/13/23 Approved Oncotype DX for Prostate Cancer
2023-ACLA-2116 OVA1 6/29/23 8/13/23 Approved OVA1
2023-ACLA-2117 PancraGEN 6/29/23 8/13/23 Approved PancraGEN
2023-ACLA-2118 Pathology Testing with Mohs Micrographic Surgery 6/29/23 8/13/23 Approved Pathology Testing with Mohs Micrographic Surgery
2023-ACLA-2119 CA3 Testing for Prostate Cancer 6/29/23 8/13/23 Approved CA3 Testing for Prostate Cancer
2023-ACLA-2120 Peutz-Jeghers Syndrome Genetic Testing 6/29/23 8/13/23 Approved Peutz-Jeghers Syndrome Genetic Testing
2023-ACLA-2121 Prenatal Aneuploidy FISH Testing 6/29/23 8/13/23 Approved Prenatal Aneuploidy FISH Testing
2023-ACLA-2122 Prenatal Maternal Serum Screening 6/29/23 8/13/23 Approved Prenatal Maternal Serum Screening
2023-ACLA-2123 Prolaris 6/29/23 8/13/23 Approved Prolaris
2023-ACLA-2124 Prosigna Breast Cancer Prognostic Gene Signature Assay 6/29/23 8/13/23 Approved Prosigna Breast Cancer Prognostic Gene Signature Assay
2023-ACLA-2125 PTEN Hamartoma Tumor Syndromes Genetic Testing 6/29/23 8/13/23 Approved PTEN Hamartoma Tumor Syndromes Genetic Testing
2023-ACLA-2126 Rett syndrome Genetic Testing 6/29/23 8/13/23 Approved Rett syndrome Genetic Testing
2023-ACLA-2127 SARS-CoV-2 (COVID-19) 6/29/23 8/13/23 Approved SARS-CoV-2 (COVID-19)
2023-ACLA-2128 SelectMDx 6/29/23 8/13/23 Approved SelectMDx
2023-ACLA-2129 SEPT9 Methylation Analysis for colorectal Cancer 6/29/23 8/13/23 Approved SEPT9 Methylation Analysis for colorectal Cancer
2023-ACLA-2130 Somatic Mutation Testing-Hematological Malignancies 6/29/23 8/13/23 Approved Somatic Mutation Testing-Hematological Malignancies
2023-ACLA-2131 Somatic Mutation Testing Solid Tumors 6/29/23 8/13/23 Approved Somatic Mutation Testing Solid Tumors
2023-ACLA-2092 Cologuard Screening for Colorectal Cancer 6/28/23 8/12/23 Approved Cologuard Screening for Colorectal Cancer
2023-ACLA-2093 ConfirmMDx for Prostate Cancer Risk 6/28/23 8/12/23 Approved ConfirmMDx for Prostate Cancer Risk
2023-ACLA-2094 Cxbladder 6/28/23 8/12/23 Approved Cxbladder
2023-ACLA-2095 Cystic fibrosis Testing 6/28/23 8/12/23 Approved Cystic fibrosis Testing
2023-ACLA-2096 Decipher Prostate Cancer classifier 6/28/23 8/12/23 Approved Decipher Prostate Cancer classifier
2023-ACLA-2097 DecisionDx Uveal Melanoma 6/28/23 8/12/23 Approved DecisionDx Uveal Melanoma
2023-ACLA-2098 Dentatorubral-Pallidoluysian Atrophy Genetic Testing 6/28/23 8/12/23 Approved Dentatorubral-Pallidoluysian Atrophy Genetic Testing
2023-ACLA-2099 DermTech Pigmented Lesion Assay 6/28/23 8/12/23 Approved DermTech Pigmented Lesion Assay
2023-ACLA-2100 Dilated Cardiomyopathy Genetic Testing 6/28/23 8/12/23 Approved Dilated Cardiomyopathy Genetic Testing
2023-ACLA-2101 Duchenne and Becker Muscular Dystrophy Genetic Testing 6/28/23 8/12/23 Approved Duchenne and Becker Muscular Dystrophy Genetic Testing
2023-ACLA-2102 Early Onset Familial Alzheimer disease Genetic Testing 6/28/23 8/12/23 Approved Early Onset Familial Alzheimer disease Genetic Testing
2023-ACLA-2103 Ehlers-Danlos Syndrome Genetic Testing 6/28/23 8/12/23 Approved Ehlers-Danlos Syndrome Genetic Testing
2023-ACLA-2104 EndoPredict for Breast Cancer Prognosis 6/28/23 8/12/23 Approved EndoPredict for Breast Cancer Prognosis
2023-ACLA-2105 Epilepsy Genetic Testing 6/28/23 8/12/23 Approved Epilepsy Genetic Testing
2023-ACLA-2106 Exome Sequencing 6/28/23 8/12/23 Approved Exome Sequencing
2023-ACLA-2107 Expanded Carrier Screening Panels 6/28/23 8/12/23 Approved Expanded Carrier Screening Panels
2023-ACLA-2108 Inherited Bone Marrow Failure Syndrome (IBMFS) Testing 6/28/23 8/12/23 Approved Inherited Bone Marrow Failure Syndrome (IBMFS) Testing
2023-ACLA-2109 Inherited Thrombophilia Genetic Testing 6/28/23 8/12/23 Approved Inherited Thrombophilia Genetic Testing
2023-ACLA-2110 Limb-Girdle Muscular Dystrophy Genetic Testing 6/28/23 8/12/23 Approved Limb-Girdle Muscular Dystrophy Genetic Testing
2023-ACLA-2111 Liquid Biopsy Testing 6/28/23 8/12/23 Approved Liquid Biopsy Testing
2023-ACLA-2072 Whole Genome Sequencing 6/28/23 8/12/23 Approved Whole Genome Sequencing
2023-ACLA-2073 Afirma Thyroid Cancer Classifier Tests 6/28/23 8/12/23 Approved Afirma Thyroid Cancer Classifier Tests
2023-ACLA-2074 All Map Gene Expression profiling for Heart Transplant Rejection 6/28/23 8/12/23 Approved All Map Gene Expression profiling for Heart Transplant Rejection
2023-ACLA-2075 Allo Sure for Kidney Transplant Rejection 6/28/23 8/12/23 Approved Allo Sure for Kidney Transplant Rejection
2023-ACLA-2076 Alpha-1 Antitrypsin Deficiency Testing 6/28/23 8/12/23 Approved Alpha-1 Antitrypsin Deficiency Testing
2023-ACLA-2077 Amyotrophic Lateral Sclerosis (ALS) Genetic Testing 6/28/23 8/12/23 Approved Amyotrophic Lateral Sclerosis (ALS) Genetic Testing
2023-ACLA-2078 Angelman Syndrome Testing 6/28/23 8/12/23 Approved Angelman Syndrome Testing
2023-ACLA-2079 APOE Variant Analysis for Alzheimer disease Testing 6/28/23 8/12/23 Approved APOE Variant Analysis for Alzheimer disease Testing
2023-ACLA-2080 Arrhythmogenic Right Ventricular cardiomyopathy Genetic Testing 6/28/23 8/12/23 Approved Arrhythmogenic Right Ventricular cardiomyopathy Genetic Testing
2023-ACLA-2081 Ashkenazi Jewish Carrier Screening 6/28/23 8/12/23 Approved Ashkenazi Jewish Carrier Screening
2023-ACLA-2082 Autism, Intellectual Disability, and Developmental Delay Genetic Testing 6/28/23 8/12/23 Approved Autism, Intellectual Disability, and Developmental Delay Genetic Testing
2023-ACLA-2083 CADASIL Genetic Testing 6/28/23 8/12/23 Approved CADASIL Genetic Testing
2023-ACLA-2084 Canavan Disease Genetic Testing 6/28/23 8/12/23 Approved Canavan Disease Genetic Testing
2023-ACLA-2085 Charcot-Marie-Tooth neuropathy Testing 6/28/23 8/12/23 Approved Charcot-Marie-Tooth neuropathy Testing
2023-ACLA-2086 CHARGE Syndrome Genetic testing 6/28/23 8/12/23 Approved CHARGE Syndrome Genetic testing
2023-ACLA-2087 Chromosomal analysis for Blood and Bone Marrow Cancers 6/28/23 8/12/23 Approved Chromosomal analysis for Blood and Bone Marrow Cancers
2023-ACLA-2088 Chromosomal Microarray for Developmental Disorders 6/28/23 8/12/23 Approved Chromosomal Microarray for Developmental Disorders
2023-ACLA-2089 Chromosomal Microarray for Prenatal Diagnosis 6/28/23 8/12/23 Approved Chromosomal Microarray for Prenatal Diagnosis
2023-ACLA-2090 Chromosomal Microarray for Solid Tumors 6/28/23 8/12/23 Approved Chromosomal Microarray for Solid Tumors
2023-ACLA-2091 Chromosome Analysis for Reproductive Disorders, Prenatal Testing, and Developmental Disorders 6/28/23 8/12/23 Approved Chromosome Analysis for Reproductive Disorders, Prenatal Testing, and Developmental Disorders
2023-ACLA-2052 MUTYH-Associated Polyposis Genetic Testing 6/28/23 8/12/23 Approved MUTYH-Associated Polyposis Genetic Testing
2023-ACLA-2053 Myotonic Dystrophy Type 1 Genetic Testing 6/28/23 8/12/23 Approved Myotonic Dystrophy Type 1 Genetic Testing
2023-ACLA-2054 NE Test 6/28/23 8/12/23 Approved NE Test
2023-ACLA-2055 Neurofibromatosis Type 1 Genetic Testing 6/28/23 8/12/23 Approved Neurofibromatosis Type 1 Genetic Testing
2023-ACLA-2056 Niemann-Pick Disease Type C Testing 6/28/23 8/12/23 Approved Niemann-Pick Disease Type C Testing
2023-ACLA-2057 Niemann-Pick Disease Types A and B Testing 6/28/23 8/12/23 Approved Niemann-Pick Disease Types A and B Testing
2023-ACLA-2058 Non-Invasive Prenatal Screening 6/28/23 8/12/23 Approved Non-Invasive Prenatal Screening
2023-ACLA-2059 Non-syndromic Hearing Loss and Deafness Genetic Testing 6/28/23 8/12/23 Approved Non-syndromic Hearing Loss and Deafness Genetic Testing
2023-ACLA-2060 Noonan Spectrum Disorder Genetic Testing 6/28/23 8/12/23 Approved Noonan Spectrum Disorder Genetic Testing
2023-ACLA-2061 PALB2 Genetic Testing for Breast Cancer risk 6/28/23 8/12/23 Approved PALB2 Genetic Testing for Breast Cancer risk
2023-ACLA-2062  Prader-Willi Syndrome Testing  6/28/23 8/12/23 Approved Prader-Willi Syndrome Testing
2023-ACLA-2063  Spinocerebellar Ataxia Genetic Testing  6/28/23 8/12/23 Approved Spinocerebellar Ataxia Genetic Testing
2023-ACLA-2064 Tay-Sachs Disease Testing  6/28/23 8/12/23 Approved Tay-Sachs Disease Testing 
2023-ACLA-2065 Thoracic Aortic Aneurysms and Dissections (TAAD) Panel Testing  6/28/23 8/12/23 Approved Thoracic Aortic Aneurysms and Dissections (TAAD) Panel Testing 
2023-ACLA-2066 ThyGeNEXT and ThyraMIR miRNA Gene Expression Classifier 6/28/23 8/12/23 Approved ThyGeNEXT and ThyraMIR miRNA Gene Expression Classifier
2023-ACLA-2067 ThyroSeq 6/28/23 8/12/23 Approved ThyroSeq
2023-ACLA-2068 Tissue of Origin Testing for Cancer of Unknown Primary 6/28/23 8/12/23 Approved Tissue of Origin Testing for Cancer of Unknown Primary
2023-ACLA-2069 UroVysion FISH for Bladder Cancer 6/28/23 8/12/23 Approved UroVysion FISH for Bladder Cancer
2023-ACLA-2070 VeriStrat Testing for NSCLC TKI Response 6/28/23 8/12/23 Approved VeriStrat Testing for NSCLC TKI Response
2023-ACLA-2071 Von Hippel-Lindau Disease Genetic Testing 6/28/23 8/12/23 Approved Von Hippel-Lindau Disease Genetic Testing
2023-ACLA-2032 Hypertrophic Cardiomyopathy Genetic Testing 6/28/23 8/12/23 Approved Hypertrophic Cardiomyopathy Genetic Testing
2023-ACLA-2033 Immunohistochemistry (IHC) 6/28/23 8/12/23 Approved Immunohistochemistry (IHC)
2023-ACLA-2034 Laboratory Claim Reimbursement 6/28/23 8/12/23 Approved Laboratory Claim Reimbursement
2023-ACLA-2035 Legius Syndrome Genetic Testing 6/28/23 8/12/23 Approved Legius Syndrome Genetic Testing
2023-ACLA-2036 Li-Fraumeni Syndrome Genetic Testing 6/28/23 8/12/23 Approved Li-Fraumeni Syndrome Genetic Testing
2023-ACLA-2037 Long QT Syndrome Genetic Testing 6/28/23 8/12/23 Approved Long QT Syndrome Genetic Testing
2023-ACLA-2038 Lyme Disease Testing 6/28/23 8/12/23 Approved Lyme Disease Testing
2023-ACLA-2039 Lynch Syndrome Genetic Testing 6/28/23 8/12/23 Approved Lynch Syndrome Genetic Testing
2023-ACLA-2040 Lynch Syndrome Tumor Screening Second-Tier 6/28/23 8/12/23 Approved Lynch Syndrome Tumor Screening Second-Tier
2023-ACLA-2041 Macula Risk 6/28/23 8/12/23 Approved Macula Risk
2023-ACLA-2042 Mamma Print 70-Gene Breast Cancer Recurrence Assay 6/28/23 8/12/23 Approved Mamma Print 70-Gene Breast Cancer Recurrence Assay
2023-ACLA-2043 Marfan Syndrome Genetic Testing 6/28/23 8/12/23 Approved Marfan Syndrome Genetic Testing
2023-ACLA-2044 Maturity-Onset diabetes of the Young Genetic Testing 6/28/23 8/12/23 Approved Maturity-Onset diabetes of the Young Genetic Testing
2023-ACLA-2045 Medically Necessary Laboratory Testing 6/28/23 8/12/23 Approved Medically Necessary Laboratory Testing
2023-ACLA-2046 Mitochondrial Disorders Genetic Testing 6/28/23 8/12/23 Approved Mitochondrial Disorders Genetic Testing
2023-ACLA-2047 Microsatellite Instability and Immunohistochemistry Testing in Cancer 6/28/23 8/12/23 Approved Microsatellite Instability and Immunohistochemistry Testing in Cancer
2023-ACLA-2048 Molecular Gastrointestinal Pathogen Panel (GIPP) Testing 6/28/23 8/12/23 Approved Molecular Gastrointestinal Pathogen Panel (GIPP) Testing
2023-ACLA-2049 Molecular Respiratory Infection Pathogen Panel (RIPP) Testing 6/28/23 8/12/23 Approved Molecular Respiratory Infection Pathogen Panel (RIPP) Testing
2023-ACLA-2050 Multiple Endocrine Neoplasic Type 1 Genetic Testing 6/28/23 8/12/23 Approved Multiple Endocrine Neoplasic Type 1 Genetic Testing
2023-ACLA-2051 Multiple Endocrine Neoplasic Type 2 Genetic Testing 6/28/23 8/12/23 Approved Multiple Endocrine Neoplasic Type 2 Genetic Testing
2023-ACLA-2012 Familial Hypercholesterolemia Genetic Testing 6/28/23 8/12/23 Approved Familial Hypercholesterolemia Genetic Testing
2023-ACLA-2013 Familial Malignant Melanoma Genetic Testing 6/28/23 8/12/23 Approved Familial Malignant Melanoma Genetic Testing
2023-ACLA-2014 Fibro Test. Fibro SURE 6/28/23 8/12/23 Approved Fibro Test. Fibro SURE
2023-ACLA-2015 Flow Cytometry 6/28/23 8/12/23 Approved Flow Cytometry
2023-ACLA-2016 FMR1-Related Disorders (Fragile X) 6/28/23 8/12/23 Approved FMR1-Related Disorders (Fragile X)
2023-ACLA-2017 Friedreich Ataxia Genetic Testing 6/28/23 8/12/23 Approved Friedreich Ataxia Genetic Testing
2023-ACLA-2018 Gene Sight Psychotropic Test 6/28/23 8/12/23 Approved Gene Sight Psychotropic Test
2023-ACLA-2019 Genitourinary Conditions Molecular Testing 6/28/23 8/12/23 Approved Genitourinary Conditions Molecular Testing
2023-ACLA-2020 Hemoglobinopathies Genetic Testing 6/28/23 8/12/23 Approved Hemoglobinopathies Genetic Testing
2023-ACLA-2021 Hereditary Ataxia Multigene Panel Genetic Testing 6/28/23 8/12/23 Approved Hereditary Ataxia Multigene Panel Genetic Testing
2023-ACLA-2022 Hereditary Cancer Syndrome Multigene Panels 6/28/23 8/12/23 Approved Hereditary Cancer Syndrome Multigene Panels
2023-ACLA-2023 Hereditary Connective Tissue Disorder Testing 6/28/23 8/12/23 Approved Hereditary Connective Tissue Disorder Testing
2023-ACLA-2024 Hereditary Pancreatitis Genetic Testing 6/28/23 8/12/23 Approved Hereditary Pancreatitis Genetic Testing
2023-ACLA-2025 HFE Hemochromatosis Testing 6/28/23 8/12/23 Approved HFE Hemochromatosis Testing
2023-ACLA-2026 HIV Tropism Testing for Maraviroc Response 6/28/23 8/12/23 Approved HIV Tropism Testing for Maraviroc Response
2023-ACLA-2027 HLA Typing for Celiac Disease 6/28/23 8/12/23 Approved HLA Typing for Celiac Disease
2023-ACLA-2028 Human Immunodeficiency Virus Laboratory Testing 6/28/23 8/12/23 Approved Human Immunodeficiency Virus Laboratory Testing
2023-ACLA-2029 Human Papillomavirus (HPV) Molecular Testing 6/28/23 8/12/23 Approved Human Papillomavirus (HPV) Molecular Testing
2023-ACLA-2030 Human Platelet and Red Blood Cell Antigen Genotyping 6/28/23 8/12/23 Approved Human Platelet and Red Blood Cell Antigen Genotyping
2023-ACLA-2031 Huntington Disease 6/28/23 8/12/23 Approved Huntington Disease
2023-ACLA-1990 Sleep Diagnostics 6/28/23 8/12/23 Approved Sleep Diagnostics
2023-ACLA-1991 Sleep Disordered Breathing Diagnosis and Treatment General Guidelines 6/28/23 8/12/23 Approved Sleep Disordered Breathing Diagnosis and Treatment General Guidelines
2023-ACLA-1992 Sleep Disordered Breathing Diagnosis and Treatment Place of Service 6/28/23 8/12/23 Approved Sleep Disordered Breathing Diagnosis and Treatment Place of Service
2023-ACLA-1994 Criteria to Determine Medical Necessity for Skilled Physical-Occupational Therapy Care 6/28/23 8/12/23 Approved Criteria to Determine Medical Necessity for Skilled Physical-Occupational Therapy Care
2023-ACLA-1995 Integumentary Considerations 6/28/23 8/12/23 Approved Integumentary Considerations
2023-ACLA-1996 Lymphatic Considerations 6/28/23 8/12/23 Approved Lymphatic Considerations
2023-ACLA-1997 Musculoskeletal Considerations 6/28/23 8/12/23 Approved Musculoskeletal Considerations
2023-ACLA-1999 Pediatric Neurodevelopmental Considerations 6/28/23 8/12/23 Approved Pediatric Neurodevelopmental Considerations
2023-ACLA-2000 Pelvic Considerations 6/28/23 8/12/23 Approved Pelvic Considerations
2023-ACLA-2001 Swallowing and Feeding Considerations 6/28/23 8/12/23 Approved Swallowing and Feeding Considerations
2023-ACLA-2002 Vestibular Considerations 6/28/23 8/12/23 Approved Vestibular Considerations
2023-ACLA-2003 4K Score for Prostate Cancer Risk Assessment 6/28/23 8/12/23 Approved 4K Score for Prostate Cancer Risk Assessment
2023-ACLA-2004 BCR-ABL Negative Myeloproliferative Neoplasm Testing 6/28/23 8/12/23 Approved BCR-ABL Negative Myeloproliferative Neoplasm Testing
2023-ACLA-2005 Bloom Syndrome Genetic Testing 6/28/23 8/12/23 Approved Bloom Syndrome Genetic Testing
2023-ACLA-2006 BRCA Analysis 6/28/23 8/12/23 Approved BRCA Analysis
2023-ACLA-2007 BRCA Ashkenazi Jewish Founder Mutation 6/28/23 8/12/23 Approved BRCA Ashkenazi Jewish Founder Mutation
2023-ACLA-2008 Breast Cancer Index for Breast Cancer Prognosis 6/28/23 8/12/23 Approved Breast Cancer Index for Breast Cancer Prognosis
2023-ACLA-2009 Brugada Syndrome Genetic Testing 6/28/23 8/12/23 Approved Brugada Syndrome Genetic Testing
2023-ACLA-2010 Facioscapulohumeral Muscular Dystrophy Genetic Testing 6/28/23 8/12/23 Approved Facioscapulohumeral Muscular Dystrophy Genetic Testing
2023-ACLA-2011 Familial Adenomatous Polyposis Genetic Testing 6/28/23 8/12/23 Approved Familial Adenomatous Polyposis Genetic Testing
2023-ACLA-1185 Individual Placement and Support 6/27/23 8/11/23 Approved Individual Placement and Support
2023-LHCC-1962 Provider Notifications 6/27/23 8/11/23 Approved Provider Notifications
2023-ACLA-1963 Cranial Hair Prosthesis 6/27/23 8/11/23 Approved Cranial Hair Prosthesis
2023-ACLA-1964 Custom Fabricated Devices 6/27/23 8/11/23 Approved Custom Fabricated Devices
2023-ACLA-1967 Custom Fit DME 6/27/23 8/11/23 Approved Custom Fit DME
2023-ACLA-1969 Mobility Power Wheelchair repairs and Replacement Accessories 6/27/23 8/11/23 Approved Mobility Power Wheelchair repairs and Replacement Accessories
2023-ACLA-1971 Musculoskeletal Pediatric Foot Orthotics and Orthopedic Shoes 6/27/23 8/11/23 Approved Musculoskeletal Pediatric Foot Orthotics and Orthopedic Shoes
2023-ACLA-1972 Musculoskeletal Spinal Orthoses 6/27/23 8/11/23 Approved Musculoskeletal Spinal Orthoses
2023-ACLA-1973 Musculoskeletal Static Upper Extremity Orthoses 6/27/23 8/11/23 Approved Musculoskeletal Static Upper Extremity Orthoses
2023-ACLA-1974 Replacement and Continued Use of DME 6/27/23 8/11/23 Approved Replacement and Continued Use of DME
2023-ACLA-1975 Respiratory High Frequency Chest Wall Oscillation systems 6/27/23 8/11/23 Approved Respiratory High Frequency Chest Wall Oscillation systems
2023-ACLA-1977 Skin and Wound Care Negative Pressure Wound Therapy 6/27/23 8/11/23 Approved Skin and Wound Care Negative Pressure Wound Therapy
2023-ACLA-1978 Skin and Wound Care Pneumatic Compression Devices 6/27/23 8/11/23 Approved Skin and Wound Care Pneumatic Compression Devices
2023-ACLA-1979 Standing Frames 6/27/23 8/11/23 Approved Standing Frames
2023-ACLA-1980 Stimulators - Transcutaneous Electrical Nerve Stimulation 6/27/23 8/11/23 Approved Stimulators - Transcutaneous Electrical Nerve Stimulation
2023-ACLA-1982 Indications Diagnostic Testing 6/27/23 8/11/23 Approved Indications Diagnostic Testing
2023-ACLA-1983 Maintenance of Wakefulness Testing 6/27/23 8/11/23 Approved Maintenance of Wakefulness Testing
2023-ACLA-1985 Pediatric Sleep Guidelines 6/27/23 8/11/23 Approved Pediatric Sleep Guidelines
2023-ACLA-1987 PSG and Multiple Sleep Latency Testing 6/27/23 8/11/23 Approved PSG and Multiple Sleep Latency Testing
2023-ACLA-1988 Repeat Sleep Testing 6/27/23 8/11/23 Approved Repeat Sleep Testing

 

Surgeon General Ralph L. Abraham, M.D.

Secretary Bruce D. Greenstein

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