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 |
|---|---|---|---|
| Bath bench/chair (non-Hospice) | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Batteries | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Bed pan | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Bedwetting/enuresis alarms | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Belimumab (Benlysta®) | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Belinostat (Beleodaq®) | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Bevacizimab (Avastin®) | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Bilirubin lights | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Bio-identical hormone replacement and saliva hormone testing for treatment of menopause | Medical Services Investigational | CoOportunity Health Iowa Nebraska | No |
| Biofeedback for behavioral health applications | Equipment/Supplies Behavioral Health | CoOportunity Health Iowa Nebraska | No |
| Biofeedback medical applications - Iowa | Ancillary Services | CoOportunity Health Iowa | No |
| Biofeedback – medical applications - Nebraska | Equipment/Supplies | Nebraska | No |
| Birth centers | Medical Services | CoOportunity Health Iowa Nebraska | No |
| Blepharoplasty/ptosis repair, brow lift | Surgery | CoOportunity Health Iowa Nebraska | Yes |
| Blinatumomab (Blincyto™) | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Blood factor products | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Blood pressure monitors/units | Equipment/Supplies | CoOportunity Health Iowa Nebraska | Yes |
| Bone mineral densitometry | Diagnostic Imaging | CoOportunity Health Iowa Nebraska | No |
| Bone stimulators, electronic and ultrasonic | Equipment/Supplies | CoOportunity Health Iowa Nebraska | Yes |
| Botulinum toxins: abobotulinumtoxinA (Dysport®), incobotulinumtoxinA (Xeomin®), onabotulinumtoxinA (Botox®) | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Brachytherapy for prostate cancer | Medical Services | CoOportunity Health Iowa Nebraska | No |
| Breast prosthesis | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Breast pumps | Equipment/Supplies | CoOportunity Health Iowa Nebraska | Yes |
| Breast specific gamma imaging (BSGI) | Diagnostic Imaging | CoOportunity Health Iowa Nebraska | Yes |
| Breast surgery | Surgery | CoOportunity Health Iowa Nebraska | Yes |
| Brentuximab vedotin (Adcetris®) | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Bronchial drainage (BD) board | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Bronchial drainage (BD) table | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Bronchial thermoplasty | Medical Services | CoOportunity Health Iowa Nebraska | Yes |
| Bronchial valve placement in emphysema | Surgery | 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.