services requiring prior authorization - Oxford Health Plans
services requiring prior authorization - Oxford Health Plans
services requiring prior authorization - Oxford Health Plans
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Clinical Mandibular Disorders 04/01/2013<br />
Clinical Manipulation Under Anesthesia 04/01/2013<br />
Clinical Manipulative Therapy 07/01/2013<br />
Clinical<br />
Mastectomy/Lumpectomy and Lymph Node Dissection - Place of Service<br />
and Length of Stay<br />
10/01/2013<br />
Clinical Mechanical Stretching and Continuous Passive Motion Devices 07/01/2013<br />
Clinical Mekinist (Trametinib) 01/01/2014<br />
Clinical Meniscus Implant and Allograft 11/01/2012<br />
Clinical Modafinil (Provigil) and Armodafinil (Nuvigil) 01/01/2014<br />
Clinical Motorized Spinal Traction 08/01/2013<br />
Clinical<br />
Multiple Sclerosis: Interferon B-1A (Avonex, Rebif), Interferon B-1B<br />
(Betaseron, Extavia), Glatiramer (Copaxone) and Fingolimod (Gilenya)<br />
01/01/2014<br />
N<br />
Clinical Nerve Graft to Restore Erectile Function During Radical Prostatectomy 01/01/2014<br />
Clinical Neurophysiologic Testing 03/01/2013<br />
Clinical Nexavar® (Sorafenib Tosylate) 10/01/2013<br />
Clinical<br />
Noninvasive Prenatal Diagnosis of Fetal Aneuploidy Using Cell-Free Fetal<br />
Nucleic Acids in Maternal Blood<br />
01/01/2014<br />
Clinical Non-Surgical Treatment of Obstructive Sleep Apnea 07/01/2013<br />
O<br />
Clinical Obstetrical Ultrasonography 07/01/2013<br />
Clinical Occipital Neuralgia and Cervicogenic Cluster and Migraine Headaches 06/01/2013<br />
Clinical Omega-3-Acid Ethyl Esters (Lovaza) 02/15/2013<br />
Clinical Omnibus Codes 01/01/2014<br />
Clinical Onfi (Clobazam) 07/01/2013<br />
Clinical<br />
Opioid Dependence Agents: Buprenorphine HCL and Naloxone and<br />
Buprenorphine HCL<br />
01/01/2014<br />
Clinical Oral and Nasal Fentanyl Medications 01/01/2014<br />
Clinical<br />
Oral Chemotherapy Drugs: Application of NCCN Clinical Practice<br />
Guidelines<br />
01/01/2014<br />
Clinical Orencia (Abatacept)-Intravenous Infusion 05/01/2013<br />
Clinical Orthognathic/Jaw Surgery 12/01/2012<br />
Clinical Orthopedic Services 04/01/2013<br />
Clinical Oscillatory Positive Expiratory Pressure Devices 05/01/2013<br />
Clinical Osteochondral Grafting of Knee 01/01/2014<br />
Clinical Otoacoustic Emissions Testing 07/01/2012<br />
Clinical Outpatient Cardiovascular Telemetry 05/01/2013<br />
Clinical<br />
Outpatient Physical and Occupational Therapy (Optum<strong>Health</strong> Care<br />
Solutions Arrangement)<br />
04/01/2013<br />
P<br />
Services Requiring Prior Authorization 6<br />
©1996-2014, <strong>Oxford</strong> <strong>Health</strong> <strong>Plans</strong>, LLC
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