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 |
|---|---|---|---|
| Magnetic resonance imaging (MRI) focused ultrasound ablation for uterine fibroids | Surgery | CoOportunity Health Iowa Nebraska | No |
| Maintenance care | Other | CoOportunity Health Iowa Nebraska | No |
| Massage therapy | Ancillary Services | CoOportunity Health Iowa Nebraska | No |
| Mechanical stretch devices | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Medic alert bracelet | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Medically necessary/medical necessity | Medical Services | CoOportunity Health Iowa Nebraska | No |
| Medication therapy disease management program | Pharmacy | CoOportunity Health Iowa Nebraska | No |
| Medications for risk reduction of primary breast cancer in women | Pharmacy Preventive | CoOportunity Health Iowa Nebraska | Yes |
| Meniere's disease treatment – Meniett device | Equipment/Supplies | CoOportunity Health Iowa Nebraska | No |
| Mesenchymal stem cell therapy for orthopedic indications | Investigational Surgery | CoOportunity Health Iowa Nebraska | No |
| Microprocessor knee prosthetic | Equipment/Supplies | CoOportunity Health Iowa Nebraska | Yes |
| Minimally invasive & laser spine procedures | Spine Investigational Surgery | CoOportunity Health Iowa Nebraska | Yes |
| MiniMaze™ procedure | Surgery | CoOportunity Health Iowa Nebraska | No |
| Minimum/maximum drug dosage | Pharmacy | CoOportunity Health Iowa Nebraska | No |
| Mole, nevus, lipoma or skin lesion removal | Medical Services | CoOportunity Health Iowa Nebraska | No |
| Mozobil (Plerixafor®) | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Mucopolysaccharidoses (MPS) drug therapy | Pharmacy | CoOportunity Health Iowa Nebraska | Yes |
| Musculoskeletal treatment (chiropractic) services | Medical Services | 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.