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 |
|---|---|---|---|
| Immune globulin therapy | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Immunizations | Pharmacy Preventive | CoOportunity Health Iowa Nebraska | No |
| Implantable vagus nerve stimulation (VNS) | Surgery Behavioral Health | CoOportunity Health Iowa Nebraska | Yes |
| In vitro fertilization (IVF) and other advanced assisted reproductive technology (ART) | Medical Services | CoOportunity Health Iowa Nebraska | No |
| In-exsufflation devices | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| In-home mental health psychotherapy services | Behavioral Health | CoOportunity Health Iowa Nebraska | Yes |
| Infertility diagnosis – female | Medical Services | CoOportunity Health Iowa Nebraska | No |
| Infertility diagnosis – male | Medical Services | CoOportunity Health Iowa Nebraska | No |
| Infertility treatment – female | Medical Services | CoOportunity Health Iowa Nebraska | No |
| Infertility treatment – male | Medical Services | CoOportunity Health Iowa Nebraska | No |
| Infliximab (Remicade®) | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Insulin pumps | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Intensive dietary counseling for obesity for adults | Ancillary Services Medical Services | CoOportunity Health Iowa Nebraska | No |
| Intensive early intervention behavioral therapy (IEIBT) | Behavioral Health | CoOportunity Health Iowa | No |
| Interferential current stimulation (IFC) | Equipment/Supplies Investigational | CoOportunity Health Iowa Nebraska | No |
| Intermittent positive pressure breathing (IPPB) | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Interspinous process decompression to treat spinal stenosis (X–STOP®) | Surgery | CoOportunity Health Iowa Nebraska | No |
| Intra-articular Hyaluronan (Viscosupplementation) | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Intraocular lens (IOL) implant after cataract surgery | Surgery | CoOportunity Health Iowa Nebraska | No |
| Intraoperative monitoring (IOM) of electromyographic (EMG) responses during spinal surgery | Surgery | CoOportunity Health Iowa Nebraska | No |
| Intrathecal baclofen | Medical Services | CoOportunity Health Iowa Nebraska | No |
| Intravenous (IV) therapy and pump supplies | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Investigational services | Investigational Behavioral Health | CoOportunity Health Iowa Nebraska | Yes |
| Investigational services - list of non-covered services | Investigational Behavioral Health Spine | CoOportunity Health Iowa Nebraska | No |
| Investigational services – category III codes | Investigational | CoOportunity Health Iowa Nebraska | Yes |
| Iontophoresis | Medical Services Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Ipilimumab (Yervoy™) | Pharmacy | CoOportunity Health Iowa Nebraska | No |
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CoOportunity Health has contracted with HealthPartners Administrators, Inc. to provide claims processing, medical management and certain other administrative services.