This section of the Medical Policy Reference Manual includes policies pertaining to the clinical specialty areas of medicine.
Medical policies in this section encompass the diagnosis, treatment, and medical care of disease and the maintenance of health within the following specialties:
- allergy and immunology—evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system;
- endocrinology—diagnosis and treatment of disorders of the endocrine glands such as the thyroid and adrenal glands and disorders such as diabetes, metabolic and nutritional disorders, and pituitary diseases;
- gastroenterology—diagnosis and treatment of the digestive organs involving the stomach, bowels, liver, and gallbladder;
- geriatrics—diagnostic, therapeutic, preventive, and rehabilitative aspects of illness in the elderly;
- hematology—diagnosis and treatment of diseases in the blood, spleen, and lymph glands;
- infectious disease—treatment of clinically manifest medical problems arising from microbial parasitism of human hosts, and invading microorganisms and the defense mechanisms of the invaded host which can take place in all organs;
- nephrology—diagnosis and treatment of kidney disorders, high blood pressure, fluid and mineral balance, and dialysis of body wastes;
- pulmonary disease—diagnosis and treatment of diseases of the lungs and airways, including sleep-related disorders;
- rheumatology—diagnosis and treatment of diseases of joints, muscle, bones, and tendons;
- sports medicine—treatment and prevention of injuries resulting from exercise or participation in sports;
- pediatrics—prevention, diagnosis, and treatment of disease in children;
- genetics—therapeutic or diagnostic procedures for patients with genetic-linked diseases;
- emergency medicine—treatment of life-threatening injury or illness and disability;
- dermatology—medical care and treatment of disorders of the skin;
- otolaryngology—medical care and treatment of diseases and disorders that affect the ears, the respiratory and upper alimentary systems, and related structures of the head and neck in general;
- preventive medicine—protection, promotion, and maintenance of health and well-being, and the prevention of disease, disability, and premature death.
Specific subsections are indicated for the medical specialties of cardiology, oncology, and pathology.