Coverage criteria policies

CoOportunity 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 name	Policy category	Product	Prior authorization required
Labor charges, repairs and parts for Durable Medical Equipment (DME) – prosthetics and orthotics	Equipment/Supplies	CoOportunity Health Iowa Nebraska	No
Laser treatment for skin conditions	Medical Services	CoOportunity Health Iowa Nebraska	No
Laser-assisted uvulopalatoplasty (LAUP)	Surgery	CoOportunity Health Iowa Nebraska	No
Lift chair mechanism	Equipment/Supplies	CoOportunity Health Iowa Nebraska	Yes
Light therapy unit for seasonal affective disorder	Equipment/Supplies	CoOportunity Health Iowa Nebraska	No
Lipid apheresis	Medical Services	CoOportunity Health Iowa Nebraska	No
Low level laser therapy (cold laser) and high power laser therapy	Investigational	CoOportunity Health Iowa Nebraska	No
Low-dose computed tomography (CT) for screening for lung cancer	Diagnostic Imaging Medical Services Preventive	CoOportunity Health Iowa Nebraska	No
Lyme disease – antibiotic treatment	Pharmacy	CoOportunity Health Iowa Nebraska	No