Services not covered by Priority Health

There are hundreds of services not covered by our medical plans and it's impossible to list them all, but here is a brief list of some that cause frequent inquiries.

Service or device Medical policy
Abortion, recurrent spontaneous 91156
Automated percutaneous lumbar discectomy (APLD) 91581
Autopsy 91054
AxiaLIF™ lumbar interbody fusion
Cingulotomy 91475
Extracorporeal shock wave therapy (ECWT) 91527
Health education materials   
IDET and other thermal intradiscal procedures (TIPs) 91581
Intracranial angioplasty and stenting 91495
Irreversible electroporation (IRE) or Nanoknife® 91599
Patellofemoral replacement for isolated osteoarthritis of the knee 91571
Phototherapy, monochromatic (anodyne therapy/ MIRE therapy/ low-level light therapy) 91486
Platelet-rich plasma/ platelet-rich fibrin matrix  91553
Refractive keeratoplasty/ LASIK 91529
Respite care 91321
Sperm and oocyte retrieval and storage 91393
Therapy, craniosacral
Therapy, tinnitus retraining 91482
Thermal capsulorrhaphy 91551
Thermography 91355
Ultrasound, high-intensity focused 91601
Ultrasound ablation of uterine fibroids 91573