HealthPartners: Cohere Medicare Advantage & Commercial/Medicaid Policies

In this article, you can find Cohere guidelines for HealthPartners members with the following coverage:

• Medicare Advantage (MA) 
• Commercial / Medicaid 

Cohere Guidelines: Medicare Advantage (MA)
Line of Business	Service
Medicare Advantage (MA)	Musculoskeletal  Ankle Arthrodesis Ankle Arthroplasty Bunionette Surgical Treatments Cervical Spinal Fusion Genicular Nerve Procedures Great Toe Surgical Treatments Hammertoe, Claw Toe, or Mallet Toe Surgical Treatment with or without Fusion Hip Arthroplasty Hip Arthroscopy Interphalangeal Joint Arthroplasty Interspinous Process Devices with Decompression Interspinous Process Devices without Decompression Intradiscal Biacuplasty, PIRFT, or IDET Intrathecal Pain Pumps Knee Arthroplasty Knee Arthroscopy Kyphectomy Lumbar Spinal Fusion Sacroiliac Joint Fusion Shoulder Arthroplasty Shoulder Arthroscopy Spinal Decompression Subchondroplasty Tarsometatarsal Arthrodesis Thermal Ablation of the Intraosseous Basivertebral Nerve Total Disc Arthroplasty Vertebral Body Tethering Vertebral Corpectomy Xenograft Implantation
Medicare Advantage (MA)	Cardiovascular  Cardiac Ablation Cardiac Implantable Devices  Cardiac Contractility Modulation (CCM) Carotid Artery Stenting (CAS) and/or Transcarotid Artery Revascularization (TCAR) Carotid Artery Stenting (CAS) and/or Transcarotid Artery Revascularization (TCAR) without Distal Embolic Protection   Catheter-based Angiogram, Lower Extremity Arteries  Coronary Artery Atherectomy Descending Thoracic and Abdominal Aortic Repair  Leadless Cardiac Pacemakers Left and Right Heart Catheterization  Left Heart Catheterization (Coronary Angiography and/or Bypass Angiography) Patent Foramen Ovale (PFO) and Atrial Septal Defect (ASD) Closure  Percutaneous Coronary Intervention/Angioplasty/Stent Right Heart Catheterization and/or Left Ventriculogram  Wireless Pulmonary Artery Pressure Monitoring (CardioMEMS)

Cohere Guidelines: Commercial / Medicaid
Line of Business	Service
Commercial / Medicaid	Musculoskeletal Ankle Arthrodesis Ankle Arthroplasty Bunionette Surgical Treatments Cervical Spinal Fusion Epidural Steroid Injections (ESI) Facet Joint Allograft Implants Facet Injections Facet Joint Radiofrequency Ablation (RFA) Genicular Nerve Procedures  Great Toe Surgical Treatments  Hammertoe, Claw Toe, or Mallet Toe Surgical Treatment with or without Fusion  Hip Arthroplasty (Partial, Total, or Revision) Hip Arthroscopy  Internal Loop Recorders Interphalangeal Joint Arthroplasty Interspinous Process Devices with Open Decompression Interspinous Process Devices without Open Decompression Intradiscal Biacuplasty, Percutaneous Intradiscal Radiofrequency Thermocoagulation (PIRFT), or Intradiscal Electrothermal Therapy (IDET) Intrathecal Pain Pumps Knee Arthroplasty Knee Arthroscopy  Kyphectomy Kyphoplasty and Vertebroplasty Lumbar or Thoracic Spinal Fusion Pediatric Arthroscopy Procedures (Hip, Knee, Shoulder) Pediatric Vertebral Body Tethering Sacroiliac Joint Injections and Radiofrequency Ablation (RFA) Sacroiliac Joint Fusion SI Joint Injections  Shoulder Arthroplasty Shoulder Arthroscopy Spinal Cord Stimulators Spinal Decompression Subchondroplasty Tarsometatarsal Arthrodesis  Thermal Ablation of the Intraosseous Basivertebral Nerve (BVN) Total Disc Arthroplasty Vertebral Body Tethering Vertebral Corpectomy Xenograft Implantation
Commercial / Medicaid	Cardiovascular Cardiac Ablation Cardiac Implantable Devices Cardiac Contractility Modulation (CCM) Carotid Artery Stenting (CAS) and/or Transcarotid Artery Revascularization (TCAR) Carotid Endarterectomy Catheter-based Angiogram, Lower Extremity Arteries  Coronary Atherectomy Descending Thoracic and Abdominal Aortic Repair Electrophysiological Study (EPS) External Wearable Devices Leadless Cardiac Pacemakers Left and Right Heart Catheterization Left Atrial Appendage Implants Left Heart Catheterization Lower Extremity Arterial Revascularization Patent Foramen Ovale (PFO) and Atrial Septal Defect (ASD) Closure Percutaneous Coronary Intervention (PCI)/Angioplasty/Stent Percutaneous Ventricular Assist Devices Right Heart Catheterization and/or Left Ventriculogram Transcatheter Aortic Valve Replacement (TAVR)  Transcatheter Mitral Valve Repair Wireless Pulmonary Artery Pressure Monitoring (CardioMEMS)

 

Cohere Guidelines: All lines of business (Medicare/Commercial/Medicaid)
Line of Business	Service
All Lines of Business (medicare/commercial/medicaid)	Site of Service Criteria for Inpatient vs. Outpatient Services

Upcoming Policy Changes
Effective Date	Line of Business	Service
8/1/2025	Commercial / Medicaid	Diagnostic Imaging Magnetic Resonance (MR) Spectroscopy Computed Tomography (CT), Abdomen/Pelvis Computed Tomography (CT), Brain Computed Tomography (CT), Chest Computed Tomography (CT), Colonography Computed Tomography (CT), Face/Sinus Computed Tomography (CT), Lower Extremity Computed Tomography (CT), Neck (Soft Tissue) Computed Tomography (CT), Orbit/Ear/Sella Computed Tomography (CT), Spine (Cervical, Thoracic, and Lumbar) Computed Tomography (CT), Upper Extremity Computed Tomography Angiography (CTA), Abdomen/Pelvis, including Lower Extremity RunOff Computed Tomography Angiography (CTA), Chest Computed Tomography Angiography (CTA), Head Computed Tomography Angiography (CTA), Lower Extremity Computed Tomography Angiography (CTA), Neck Computed Tomography Angiography (CTA), Upper Extremity Magnetic Resonance (MR) Elastography Magnetic Resonance Angiography (MRA), Abdomen/Pelvis Magnetic Resonance Angiography (MRA), Chest Magnetic Resonance Angiography (MRA), Head Magnetic Resonance Angiography (MRA), Lower Extremity Magnetic Resonance Angiography (MRA), Neck Magnetic Resonance Angiography (MRA), Spinal Canal Magnetic Resonance Angiography (MRA), Upper Extremity Magnetic Resonance Imaging (MRI), Abdomen and Magnetic Resonance Cholangiopancreatography (MRCP) Magnetic Resonance Imaging (MRI), Bone Marrow Magnetic Resonance Imaging (MRI), Brain Magnetic Resonance Imaging (MRI), Brain Functional Magnetic Resonance Imaging (MRI), Breast Magnetic Resonance Imaging (MRI), Cardiac Magnetic Resonance Imaging (MRI), Chest Magnetic Resonance Imaging (MRI), Lower Extremity Magnetic Resonance Imaging (MRI), Neck/Orbit/Face Magnetic Resonance Imaging (MRI), Pelvis Magnetic Resonance Imaging (MRI), Spine (Cervical, Thoracic, and Lumbar) Magnetic Resonance Imaging (MRI), Temporomandibular Joint (TMJ) Magnetic Resonance Imaging (MRI), Upper Extremity Positron Emission Tomography (PET), Brain Positron Emission Tomography (PET)/PET-Computed Tomography (CT)
8/1/2025	Medicare Advantage	Diagnostic Imaging Computed Tomography Angiography (CTA), Abdomen/Pelvis, including Lower Extremity RunOff Computed Tomography (CT), Abdomen/Pelvis Computed Tomography (CT), Brain Computed Tomography (CT), Chest Computed Tomography (CT), Colonography Computed Tomography (CT), Face/Sinus  Computed Tomography (CT), Lower Extremity Computed Tomography (CT), Neck (Soft Tissue)  Computed Tomography (CT), Orbit/Ear/Sella  Computed Tomography (CT), Spine (Cervical, Thoracic, and Lumbar) Computed Tomography (CT), Upper Extremity Computed Tomography Angiography (CTA), Chest Computed Tomography Angiography (CTA), Head Computed Tomography Angiography (CTA), Lower Extremity Computed Tomography Angiography (CTA), Neck Computed Tomography Angiography (CTA), Upper Extremity Magnetic Resonance (MR) Elastography Magnetic Resonance (MR) Spectroscopy Magnetic Resonance Angiography (MRA), Abdomen/Pelvis Magnetic Resonance Angiography (MRA), Chest Magnetic Resonance Angiography (MRA), Head Magnetic Resonance Angiography (MRA), Lower Extremity Magnetic Resonance Angiography (MRA), Neck Magnetic Resonance Angiography (MRA), Spinal Canal Magnetic Resonance Angiography (MRA), Upper Extremity Magnetic Resonance Imaging (MRI), Abdomen and Magnetic Resonance Cholangiopancreatography (MRCP)  Magnetic Resonance Imaging (MRI), Bone Marrow Magnetic Resonance Imaging (MRI), Brain Magnetic Resonance Imaging (MRI), Brain Functional Magnetic Resonance Imaging (MRI), Breast Magnetic Resonance Imaging (MRI), Cardiac Magnetic Resonance Imaging (MRI), Chest Magnetic Resonance Imaging (MRI), Lower Extremity Magnetic Resonance Imaging (MRI), Neck/Orbit/Face Magnetic Resonance Imaging (MRI), Pelvis Magnetic Resonance Imaging (MRI), Spine (Cervical, Thoracic, and Lumbar) Magnetic Resonance Imaging (MRI), Temporomandibular Joint (TMJ) Magnetic Resonance Imaging (MRI), Upper Extremity Positron Emission Tomography (PET), Brain Positron Emission Tomography (PET)/PET-Computed Tomography (CT)

 

 

 

 

• Cohere Medicare Advantage Policy - Cardiac Ablation.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Knee Arthroplasty .pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Spinal Decompression (Laminectomy, Laminotomy, Foraminotomy, and Discectomy).pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Genicular Nerve Procedures.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Cervical Spinal Fusion .pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Patent Foramen Ovale (PFO) and Atrial Septal Defect (ASD) Closure.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Interspinous Process Devices without Decompression (1).pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Interspinous Process Devices with Open Decompression .pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Xenograft Implantation.pdf
  (90 KB)
• Cohere Medicare Advantage Policy - Great Toe Surgical Treatments.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Coronary Artery Atherectomy .pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Hip Arthroscopy.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Right Heart Catheterization and_or Left Ventriculogram.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Carotid Artery Stenting (CAS) and_or Transcarotid Artery Revascularization (TCAR) without Distal Embolic Protection.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Tarsometatarsal Arthrodesis .pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Ankle Arthroplasty .pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Left Heart Catheterization (Coronary Angiography and_or Bypass Angiography).pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Percutaneous Coronary Intervention_Angioplasty_Stent.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Intradiscal Biacuplasty, PIRFT, or IDET.pdf
  (90 KB)
• Cohere Medicare Advantage Policy - Vertebral Body Tethering .pdf
  (90 KB)
• Cohere Medicare Advantage Policy - Subchondroplasty .pdf
  (90 KB)
• Cohere Medicare Advantage Policy - Intrathecal Pain Pumps.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Vertebral Corpectomy .pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Hip Arthroplasty.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Shoulder Arthroplasty.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Kyphectomy.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Shoulder Arthroscopy.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Leadless Cardiac Pacemakers.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Hammertoe, Claw Toe, or Mallet Toe Surgical Treatment with or without Fusion.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Carotid Artery Stenting (CAS) and_or Transcarotid Artery Revascularization (TCAR).pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Interspinous Process Devices without Decompression.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Bunionette Surgical Treatments.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Interphalangeal Joint Arthroplasty.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Thermal Ablation of the Intraosseous Basivertebral Nerve (BVN) .pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Total Disc Arthroplasty.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Descending Thoracic and Abdominal Aortic Repair .pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Ankle Arthrodesis .pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Left and Right Heart Catheterization .pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Wireless Pulmonary Artery Pressure Monitoring (CardioMEMS).pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Catheter-Based Angiogram, Lower Extremity Arteries.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Cardiac Implantable Devices.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Knee Arthroscopy .pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Sacroiliac Joint Fusion.pdf
  (100 KB)
• Site of Service Criteria for Inpatient vs. Outpatient Services .pdf
  (100 KB)
• Vertebral Corpectomy (Single Service).pdf
  (100 KB)
• Facet Joint Radiofrequency Ablation (RFA) (Single Service).pdf
  (100 KB)
• Thermal Ablation of the Intraosseous Basivertebral Nerve (BVN) (Single Service).pdf
  (100 KB)
• Xenograft Implantation (Single Service).pdf
  (80 KB)
• Transcatheter Aortic Valve Replacement (TAVR) (Single Service).pdf
  (100 KB)
• Total Disc Arthroplasty (Single Service).pdf
  (100 KB)
• Intradiscal Biacuplasty, PIRFT, or IDET (Single Service) .pdf
  (90 KB)
• Tarsometatarsal Arthrodesis (Single Service).pdf
  (90 KB)
• Left Atrial Appendage Implants (Single Service).pdf
  (90 KB)
• SI Joint Injections Guidelines.pdf
  (100 KB)
• Shoulder Arthroplasty (Single Service).pdf
  (100 KB)
• Subchondroplasty (Single Service).pdf
  (80 KB)
• Spinal Cord Stimulator Guideline.pdf
  (100 KB)
• Knee Arthroscopy (Single Service).pdf
  (200 KB)
• Hip Arthroplasty (Single Service) .pdf
  (100 KB)
• External Wearable Device Guideline.pdf
  (100 KB)
• Sacroiliac Joint (SIJ) Radiofrequency Ablation (RFA) Guideline.pdf
  (100 KB)
• Hip Arthroscopy Guideline.pdf
  (100 KB)
• Genicular Nerve Procedures (Single Service).pdf
  (100 KB)
• Right Heart Catheterization and_or Left Ventriculogram Guideline.pdf
  (100 KB)
• Wireless Pulmonary Artery Pressure Monitoring (CardioMEMS) (Single Service).pdf
  (100 KB)
• Electrophysiological Study (EPS) (Single Service).pdf
  (100 KB)
• Sacroiliac Joint Fusion (Single Service).pdf
  (90 KB)
• Vertebral Body Tethering (Single Service).pdf
  (80 KB)
• Transcatheter Mitral Valve Repair (Single Service).pdf
  (100 KB)
• Percutaneous Coronary Intervention_Angioplasty_Stent (Single Service).pdf
  (100 KB)
• Kyphectomy (Single Service).pdf
  (100 KB)
• Facet Injections Guideline.pdf
  (100 KB)
• Coronary Artery Atherectomy Guideline.pdf
  (100 KB)
• Cardiac Ablation (Single Service).pdf
  (100 KB)
• Knee Arthroplasty (Single Service).pdf
  (100 KB)
• Carotid Artery Stenting (CAS) and_or Transcarotid Artery Revascularization (TCAR) (Single Service).pdf
  (100 KB)
• Cervical Spinal Fusion (Single Service).pdf
  (100 KB)
• Cardiac Implantable Devices (Single Service).pdf
  (200 KB)
• Ankle Arthrodesis (Single Service) (1).pdf
  (90 KB)
• Descending Thoracic and Abdominal Aortic Repair (Single Service).pdf
  (100 KB)
• Ankle Arthrodesis (Single Service) (1) (1).pdf
  (90 KB)
• Hammertoe, Claw Toe, or Mallet Toe Surgical Treatment with or without Fusion (Single Service).pdf
  (90 KB)
• Patent Foramen Ovale (PFO) and Atrial Septal Defect (ASD) Closure (Single Service).pdf
  (100 KB)
• Interspinous Process Devices with Open Decompression (Single Service).pdf
  (100 KB)
• Interphalangeal Joint Arthroplasty (Single Service).pdf
  (100 KB)
• Leadless Cardiac Pacemakers (Single Service).pdf
  (100 KB)
• Great Toe Surgical Treatments (Single Service).pdf
  (100 KB)
• Facet Joint Allograft Implants (Single Service).pdf
  (80 KB)
• Left and Right Heart Catheterization Guideline.pdf
  (100 KB)
• Lower Extremity Arterial Revascularization (Single Service).pdf
  (100 KB)
• Lumbar Spinal Fusion (Single Service).pdf
  (100 KB)
• Carotid Endarterectomy (CEA) (Single Service).pdf
  (100 KB)
• Epidural Steroid Injections (ESI) (Outpatient) Guideline.pdf
  (100 KB)
• Intrathecal Pain Pumps (Single Service).pdf
  (100 KB)
• Catheter-Based Angiogram, Lower Extremity Arteries (Single Service).pdf
  (100 KB)
• Bunionette Surgical Treatments (Single Service).pdf
  (90 KB)
• Left Heart Catheterization Guideline.pdf
  (100 KB)
• Kyphoplasty and Vertebroplasty Guidelines.pdf
  (100 KB)
• Internal Loop Recorder Guideline.pdf
  (100 KB)
• Ankle Arthroplasty (Single Service).pdf
  (100 KB)
• Interspinous Process Devices with Open Decompression (Single Service) (1).pdf
  (100 KB)
• Shoulder Arthroscopy (Single Service).pdf
  (100 KB)
• Spinal Decompression (Single Service).pdf
  (200 KB)
• Interspinous Process Devices without Open Decompression.pdf
  (100 KB)
• Cohere Medical Policy - Pediatric Arthroscopy Procedures (Hip, Knee, Shoulder) .pdf
  (100 KB)
• Cohere Medical Policy - Pediatric Vertebral Body Tethering .pdf
  (100 KB)
• Cohere Medical Policy - Pediatric Vertebral Body Tethering .pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Facet Joint Allograft Arthroplasty.pdf
  (100 KB)
• Bunionette Surgical Treatments (Single Service) (1).pdf
  (100 KB)
• Ankle Arthroplasty (Single Service).pdf
  (100 KB)
• Cervical Spinal Fusion (Single Service).pdf
  (100 KB)
• Facet Joint Radiofrequency Ablation (RFA) (Single Service).pdf
  (100 KB)
• Ankle Arthrodesis (Single Service) (1) (1).pdf
  (100 KB)
• Ankle Arthrodesis (Single Service) (1).pdf
  (100 KB)
• Knee Arthroplasty (Single Service).pdf
  (100 KB)
• Knee Arthroscopy (Single Service).pdf
  (200 KB)
• Kyphectomy (Single Service).pdf
  (100 KB)
• Vertebral Corpectomy (Single Service).pdf
  (100 KB)
• Hammertoe, Claw Toe, or Mallet Toe Surgical Treatment with or without Fusion (Single Service).pdf
  (100 KB)
• Interphalangeal Joint Arthroplasty (Single Service).pdf
  (100 KB)
• Hip Arthroscopy Guideline.pdf
  (100 KB)
• Facet Injections Guideline.pdf
  (100 KB)
• Epidural Steroid Injections (ESI) (Outpatient) Guideline.pdf
  (200 KB)
• Tarsometatarsal Arthrodesis (Single Service).pdf
  (100 KB)
• Lumbar Spinal Fusion (Single Service).pdf
  (100 KB)
• SI Joint Injections Guidelines.pdf
  (100 KB)
• Total Disc Arthroplasty (Single Service).pdf
  (100 KB)
• Sacroiliac Joint (SIJ) Radiofrequency Ablation (RFA) Guideline.pdf
  (100 KB)
• Interspinous Process Devices with Open Decompression (Single Service).pdf
  (100 KB)
• Interspinous Process Devices without Open Decompression.pdf
  (100 KB)
• Great Toe Surgical Treatments (Single Service).pdf
  (100 KB)
• Genicular Nerve Procedures (Single Service).pdf
  (100 KB)
• Cohere Medical Policy - Cardiac Contractility Modulation (CCM).pdf
  (90 KB)
• Cohere Medicare Advantage Policy - Cardiac Contractility Modulation (CCM).pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Multiple Gated Acquisition (MUGA) Scan.pdf
  (200 KB)
• Cohere Medical Policy - Lumbar or Thoracic Spinal Fusion.pdf
  (200 KB)
• Cohere Medical Policy - Left Atrial Appendage Implants (3).pdf
  (200 KB)
• Cohere Medical Policy - Percutaneous Ventricular Assist Devices.pdf
  (200 KB)
• Cohere Medical Policy - Interspinous Process Devices with Open Decompression.pdf
  (100 KB)
• Cohere Medical Policy - Interspinous Process Devices without Open Decompression.pdf
  (100 KB)
• Cohere Medical Policy - Sacroiliac Joint Injections and Radiofrequency Ablation.pdf
  (100 KB)
• Cohere Medical Policy - Cervical Spinal Fusion.pdf
  (200 KB)
• Cohere Medical Policy - Facet Joint Radiofrequency Ablation (RFA).pdf
  (200 KB)
• Cohere Medical Policy - Ankle Arthroplasty.pdf
  (100 KB)
• Cohere Medical Policy - Hip Arthroplasty.pdf
  (500 KB)
• Cohere Medical Policy - Internal Loop Recorders.pdf
  (200 KB)
• Cohere Medical Policy - Epidural Steroid Injections (ESI).pdf
  (100 KB)
• Cohere Medical Policy - Cardiac Implantable Devices.pdf
  (200 KB)
• Cohere Medical Policy - Left Heart Catheterization .pdf
  (300 KB)
• Cohere Medical Policy - Cardiac Ablation.pdf
  (200 KB)
• Cohere Medical Policy - Total Disc Arthroplasty.pdf
  (100 KB)
• Cohere Medical Policy - Leadless Cardiac Pacemakers.pdf
  (100 KB)
• Cohere Medical Policy - External Wearable Devices.pdf
  (100 KB)
• Cohere Medical Policy - Vertebral Corpectomy .pdf
  (100 KB)
• Cohere Medical Policy - Spinal Cord Stimulators.pdf
  (200 KB)
• Cohere Medical Policy - Sacroiliac Joint Fusion.pdf
  (100 KB)
• Cohere Medical Policy - Kyphectomy.pdf
  (100 KB)
• Cohere Medical Policy - Percutaneous Coronary Intervention_Angioplasty_Stent.pdf
  (200 KB)
• Cohere Medical Policy - Knee Arthroplasty.pdf
  (600 KB)
• Cohere Medical Policy - Coronary Atherectomy.pdf
  (200 KB)
• Cohere Medical Policy - Thermal Ablation of the Intraosseous Basivertebral Nerve (BVN) .pdf
  (100 KB)
• Cohere Medical Policy - Kyphoplasty and Vertebroplasty.pdf
  (100 KB)
• Cohere Medical Policy - Facet Injections.pdf
  (200 KB)
• Cohere Medical Policy - Computed Tomography (CT), Orbit_Ear_Sella.pdf
  (200 KB)
• Cohere Medical Policy - MRI Bone Marrow.pdf
  (100 KB)
• Cohere Medical Policy - Computed Tomography (CT), Upper Extremity .pdf
  (300 KB)
• Cohere Medical Policy - Magnetic Resonance Imaging (MRI), Abdomen and Magnetic Resonance Cholangiopancreatography (MRCP).pdf
  (300 KB)
• Cohere Medical Policy - CT Brain .pdf
  (200 KB)
• Cohere Medical Policy - CT Cardiac.pdf
  (200 KB)
• Cohere Medical Policy - Computed Tomography (CT), Abdomen_Pelvis.pdf
  (200 KB)
• Cohere Medical Policy - Magnetic Resonance Angiography (MRA), Abdomen_Pelvis.pdf
  (100 KB)
• Cohere Medical Policy - CT Face_Sinus.pdf
  (100 KB)
• Cohere Medical Policy - Computed Tomography (CT), Neck (Soft Tissue).pdf
  (100 KB)
• Cohere Medical Policy - MRI Cardiac.pdf
  (100 KB)
• Radiology_MRI_Brain(Functional)_Single Service Guidelines.pdf
  (100 KB)
• Cohere Medical Policy - CTA Upper Extremity.pdf
  (100 KB)
• Cohere Medical Policy - Computed Tomography Angiography (CTA), Head.pdf
  (200 KB)
• Cohere Medical Policy - Computed Tomography (CT), Lower Extremity.pdf
  (300 KB)
• Radiology_CT_Colonography_Single Service Guidelines.pdf
  (300 KB)
• Cohere Medical Policy - Magnetic Resonance Imaging (MRI), Lower Extremity.pdf
  (300 KB)
• Cohere Medical Policy - Computed Tomography (CT), Spine (Cervical, Thoracic, and Lumbar) (1).pdf
  (300 KB)
• Cohere Medical Policy - Magnetic Resonance (MR) Spectroscopy.pdf
  (100 KB)
• Cohere Medical Policy - MRA Chest.pdf
  (200 KB)
• Cohere Medical Policy - Magnetic Resonance Imaging (MRI), Pelvis.pdf
  (200 KB)
• Cohere Medical Policy - MRI Chest.pdf
  (100 KB)
• Cohere Medical Policy - Positron Emission Tomography (PET), PET_Computed Tomography (CT) (1) (1).pdf
  (600 KB)
• Cohere Medical Policy - MRA Neck .pdf
  (200 KB)
• Cohere Medical Policy - MRI Neck_Orbit_Face.pdf
  (200 KB)
• Cohere Medical Policy - Magnetic Resonance Imaging (MRI), Breast.pdf
  (100 KB)
• Cohere Medical Policy - Magnetic Resonance Angiography (MRA), Lower Extremity.pdf
  (200 KB)
• Cohere Medical Policy - MRA Head.pdf
  (200 KB)
• Cohere Medical Policy - CT Chest.pdf
  (200 KB)
• Cohere Medical Policy - MRA Upper Extremity.pdf
  (100 KB)
• Cohere Medical Policy - Magnetic Resonance (MR) Elastography .pdf
  (100 KB)
• Cohere Medical Policy - CTA Chest.pdf
  (200 KB)
• Cohere Medical Policy - MRA Spinal Canal.pdf
  (100 KB)
• Cohere Medical Policy - CTA Lower Extremity.pdf
  (200 KB)
• Cohere Medical Policy - PET Brain (1).pdf
  (100 KB)
• Cohere Medical Policy - Computed Tomography Angiography (CTA), Neck .pdf
  (200 KB)
• Cohere Medical Policy - Magnetic Resonance Imaging (MRI), Upper Extremity.pdf
  (300 KB)
• Cohere Medical Policy - MRI TMJ.pdf
  (100 KB)
• Cohere Medical Policy - Magnetic Resonance Imaging (MRI), Spine (Cervical, Thoracic, and Lumbar) (1).pdf
  (300 KB)
• Cohere Medical Policy - Magnetic Resonance Imaging (MRI), Brain.pdf
  (200 KB)
• Cohere Medical Policy - CTA Abdomen_Pelvis.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Imaging (MRI), Brain Functional.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Computed Tomography Angiography (CTA), Chest.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - MRI Abdomen and MRCP .pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Computed Tomography Angiography (CTA), Abdomen_Pelvis, including Lower Extremity Runoff.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Computed Tomography Angiography (CTA), Neck .pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Computed Tomography Angiography (CTA), Head.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - CT Brain.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Imaging (MRI), Breast .pdf
  (300 KB)
• Cohere Medicare Advantage Policy - Computed Tomography (CT), Cardiac.pdf
  (300 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Imaging (MRI), Pelvis.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Computed Tomography (CT), Colonography .pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Computed Tomography (CT), Face_Sinus.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Imaging (MRI), Brain.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Imaging (MRI), Bone Marrow.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Angiography (MRA), Chest.pdf
  (400 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Imaging (MRI), Lower Extremity .pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Computed Tomography (CT), Spine (Cervical, Thoracic, and Lumbar).pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Computed Tomography (CT), Abdomen_Pelvis.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Computed Tomography (CT), Orbit_Ear_Sella.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Computed Tomography (CT), Chest.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Computed Tomography Angiography (CTA), Upper Extremity .pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Angiography (MRA), Neck .pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Angiography (MRA), Head .pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Imaging (MRI), Neck_Orbit_Face .pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Imaging (MRI), Temporomandibular Joint (TMJ).pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Imaging (MRI), Spine (Cervical, Thoracic, and Lumbar).pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Positron Emission Tomography (PET), PET_Computed Tomography (CT).pdf
  (300 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Imaging (MRI), Upper Extremity.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - CT Lower Extremity.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Computed Tomography Angiography (CTA), Lower Extremity.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Computed Tomography (CT), Neck (Soft Tissue).pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Computed Tomography (CT), Upper Extremity.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Angiography (MRA), Upper Extremity.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance (MR) Elastography .pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Angiography (MRA), Abdomen_Pelvis .pdf
  (300 KB)
• Cohere Medicare Advantage Policy - MR Spectroscopy.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Angiography (MRA), Spinal Canal.pdf
  (100 KB)
• Cohere Medicare Advantage Policy - Positron Emission Tomography (PET), Brain .pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Magnetic Resonance Imaging (MRI), Chest .pdf
  (100 KB)
• Cohere Medicare Advantage Policy - MRI Cardiac.pdf
  (200 KB)
• cohere_medicare_advantage_policy_-_magnetic_resonance_angiography__mra___lower_extremity.pdf
  (200 KB)
• Cohere Medicare Advantage Policy - Lumbar Spinal Fusion.pdf
  (300 KB)