A. HEALTH BENEFITS
(11) GENERAL EXCLUSIONS
· Allergy
–dust allergy apparatus,
78-178
–tests/inpatient treatment,
84-467
· Anesthesia services
·
Blood glucose monitoring,81-273
–covered under unusual circumstances,
CA-058
·
Dental services, 78-094, 78-105, 78-108, 78-112, 78-129, 78-169, 78-240, 78-282, 81-031, 81-038, 81-062, 81-139, 81-363, 81-370, 81-383, 81-385, 81-409, 81-425, 81-453, 81-544, 81-599, 81-664, 88-323
–oral orthopedic appliance,
81-544,
81-599,
81-655,
81-670,
81-676,
81-683,
84-070,
84-073,
84-315,
84-381,
88-080,
88-152,
88-355
–temporomandibular joint dysfunction (TMJ)
, 78-052,
78-067,
78-313,
81-233,
81-241,
81-544,
81-599,
81-670,
81-676,
81-683,
88-311
·
Excessive fees, 78-029, 78-144, 78-176, 78-254, 78-322, 81-079, 81-124, 81-149, 81-183, 81-184, 81-196, 81-216, 81-225, 81-265, 81-274, 81-297, 81-317, 81-326, 81-341, 81-343, 81-360, 81-366, 81-407, 81-412, 81-428, 81-541, 81-566, 81-571, 81-634, 81-656, 84-484
· Exercise equipment
–bicycle ergometer and pulsemeter,
81-415
·
Experimental medical devices and therapy,78-254, 78-320, 81-082, 81-173, 81-222, 81-230, 81-273, 81-287, 81-581, 81-591, 81-592, 81-711, 84-123, 84-222, 88-008, 88-656, 11-0136, 16-0015
–bone marrow transplant,
88-364
–emerging medical procedure,
CA-082
–light
box for seasonal affective disorder
, 88-652
–Lung Volume Reduction Surgery (LVRS),
CA-033
–morphometric analysis,
CA-032
–percutaneous diskectomy,
88-036
–Interspinous distraction device, 11-0136
–vision impaired by medical condition,
84-514
· Heart rate monitor, see exercise equipment
·
In vitro fertilization, 88-685
·
Mental deficiencies/ inpatient treatment,81-447
· Obesity, 78-104, 78-296, 81-212, 81-238, 81-476, 81-482, 84-003, 84-071, 84-247, 84-254, 84-363, 84-383, 84-434, 84-573, 84-633, 88-290, 88-413, 88-444, CA-061
·
Obstetrical charges/ excessive fee, 78-029
· Orthoptic (see heading under Vision Care)
·
Podiatrist services, routine care,84-079
·
Private duty nursing, 84-283
· Services,
–furnished by governmental, tax-support or voluntary agency,
93-068,
98-003
–not specifically provided,
78-159, 81-161,
81-238,
81-273,
84-111,
84-170,
84-241,
88-135,
88-154,
88-242,
88-321
· Visual therapy (see Vision Care listing)