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 |
|---|---|---|---|
| Ear lobe repair | Surgery | CoOportunity Health Iowa Nebraska | No |
| Eculizumab (Soliris®) | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Educational materials | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Electric Tumor Treatment Fields (ETTF) to treat glioblastoma, i.e. NovoTTF-100A | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Electrodes | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Endoscopic gastroplasty/gastroplication for GERD | Surgery | CoOportunity Health Iowa Nebraska | No |
| Enema | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Enhanced external counterpulsation (EECP) | Medical Services | CoOportunity Health Iowa Nebraska | No |
| Enteral formula and nutritional supplements | Equipment/Supplies | CoOportunity Health Iowa Nebraska | Yes |
| Epidural steroid injections (ESI) for low back pain - Effective 7/1/2015 | Medical Services Spine | CoOportunity Health Iowa Nebraska | No |
| Epidural steroid injections (ESI) for low back pain - Retire 7/1/2015 | Medical Services Spine | CoOportunity Health Iowa Nebraska | Yes |
| Equipment in skilled nursing facility/long term care facility | Equipment/Supplies | CoOportunity Health Iowa Nebraska | Yes |
| Eribulin (Halaven®) | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Erythropoiesis stimulating agents (ESA) – (e.g., Procrit®, Epogen® and Aranesp®) | Pharmacy | CoOportunity Health Iowa Nebraska | No |
| Esophageal pH monitoring | Medical Services | CoOportunity Health Iowa Nebraska | No |
| Esteem® totally implantable hearing system | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Extracorporeal shock wave treatment (ESWT) for musculoskeletal conditions | Investigational Medical Services | CoOportunity Health Iowa Nebraska | No |
| Eye surgery – refractive | Surgery | CoOportunity Health Iowa Nebraska | Yes |
| Eyewear | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Eyewear for children | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
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