Medical Policy UpdatesCoOportunity Health has Medical Policies that contain coverage criteria and guidelines that describe how we make coverage decisions for certain health care services and items. Please call our Member Services Department at 1.888.324.2064 if you have any questions.
The information presented regarding coverage criteria and guidelines is regularly updated and is subject to change without notice. Read more…
If unsure of the keyword spelling, enter the first three letters of the word followed by an asterisk (*). Example: enter acu* to locate the acupuncture policy.
Policy search filters
| Policy name | Policy category | Product | Prior authorization required |
|---|---|---|---|
| Telavancin (Vibativ®) | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Telehealth | Administrative | CoOportunity Health Iowa | No |
| Telehealth - Nebraska | Administrative | CoOportunity Health Nebraska | No |
| Temporomandibular disorder (TMD) treatments | Medical Dental | CoOportunity Health Iowa Nebraska | Yes |
| Termination of Pregnancy - Iowa | Medical Services | Iowa | No |
| Termination of Pregnancy - Nebraska | Medical Services | Nebraska | No |
| Tick borne illness laboratory testing | Laboratory | CoOportunity Health Iowa Nebraska | No |
| Tocilizumab (Actemra®) | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Topical hyperbaric oxygen (THBO) for wound healing | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Tracheostomy supplies | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Traction equipment | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Transanal endoscopic microsurgery | Surgery | CoOportunity Health Iowa Nebraska | Yes |
| Transcatheter closure device for heart conditions | Surgery | CoOportunity Health Iowa Nebraska | No |
| Transcutaneous Aortic Valve Replacement (TAVR) | Surgery | CoOportunity Health Iowa Nebraska | Yes |
| Transcutaneous electrical joint stimulation devices | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Transcutaneous electrical nerve stimulator (TENS) unit | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Transfer belt | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Transfer board | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Transjugular intrahepatic porto-systemic shunts (TIPS) | Surgery | CoOportunity Health Iowa Nebraska | No |
| Transplants | Transplants | CoOportunity Health Iowa Nebraska | Yes |
| Transurethral balloon dilation of the prostate | Surgery | CoOportunity Health Iowa Nebraska | No |
| Transurethral microwave therapy for the prostate | Surgery | CoOportunity Health Iowa Nebraska | No |
| Transurethral needle ablation (TUNA, PROSTIVA™) for benign prostatic hyperplasia | Surgery | CoOportunity Health Iowa Nebraska | No |
| Trapeze bar – over bed | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Trastuzumab (Herceptin®) | Pharmacy | CoOportunity Health Iowa Nebraska | No |
| Trend event recorder | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Truss | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Tumor chemosensitivity & chemoresistance assays | Investigational | CoOportunity Health Iowa Nebraska | No |
| Tumor markers | Medical Services | CoOportunity Health Iowa Nebraska | Yes |
| Type I Gaucher disease enzyme replacement therapy: imiglucerase (Cerezyme®), velaglucerase (Vpriv®), telaglucerase (Elelyso®) and eliglustat tartrate (Cerdelga®) | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
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CoOportunity Health has contracted with HealthPartners Administrators, Inc. to provide claims processing, medical management and certain other administrative services.