Common use of Other Diagnostic and Therapeutic Services Clause in Contracts

Other Diagnostic and Therapeutic Services. Diagnostic and Therapeutic Covered Services when authorized by a Member's PCP and HPN’s Managed Care Program include the following:  anti-cancer drug therapy;  complex allergy diagnostic services including RAST and allergoimmuno therapy;  complex diagnostic imaging services including nuclear medicine, computerized axial tomography (CT scan), cardiac ultrasonography, magnetic resonance imaging (MRI), and arthrography;  complex neurological diagnostic services including electroencephalograms (EEG), electromyogram (EMG) and evoked potential;  complex vascular diagnostic and therapeutic services including Xxxxxx monitoring, treadmill or stress testing, and impedance venous plethysmography;  complex psychological diagnostic testing;  complex pulmonary diagnostic services including pulmonary function testing and apnea monitoring;  hemodialysis and peritoneal renal dialysis;  other Medically Necessary intravenous therapeutic services as approved by HPN, including but not limited to, non-cancer related intravenous injection therapy;  otologic evaluations only for the purpose of obtaining information necessary for evaluation of the need for or appropriate type of medical or surgical treatment for a hearing deficit or a related medical problem;  Positron Emission Tomography (PET) Scans;  therapeutic radiology services; and  treatment of temporomandibular joint disorder. Different Copayment and/or Coinsurance amounts may apply to these Covered Services. Please refer to your Attachment A Benefit Schedule.

Other Diagnostic and Therapeutic Services. Diagnostic and Therapeutic Covered Services when authorized by a Member's PCP and HPN’s Managed Care Program include the following:  • anti-cancer drug therapy;  • complex allergy diagnostic services including RAST and allergoimmuno therapy;  • complex diagnostic imaging services including nuclear medicine, computerized axial tomography (CT scan), cardiac ultrasonography, magnetic resonance imaging (MRI), and arthrography;  • complex neurological diagnostic services including electroencephalograms (EEG), electromyogram (EMG) and evoked potential;  • complex vascular diagnostic and therapeutic services including Xxxxxx monitoring, treadmill or stress testing, and impedance venous plethysmography;  • complex psychological diagnostic testing;  • complex pulmonary diagnostic services including pulmonary function testing and apnea monitoring;  • hemodialysis and peritoneal renal dialysis;  • other Medically Necessary intravenous therapeutic services as approved by HPN, including but not limited to, non-cancer related intravenous injection therapy;  • otologic evaluations only for the purpose of obtaining information necessary for evaluation of the need for or appropriate type of medical or surgical treatment for a hearing deficit or a related medical problem;  • Positron Emission Tomography (PET) Scans;  • therapeutic radiology services; and  • treatment of temporomandibular joint disorder. Different Copayment and/or Coinsurance amounts may apply to these Covered Services. Please refer to your Attachment A Benefit Schedule.

Other Diagnostic and Therapeutic Services. Diagnostic and Therapeutic Covered Services when authorized by a Member's PCP and HPN’s Managed Care Program include the following:  anti-cancer drug therapy;  complex allergy diagnostic services including RAST and allergoimmuno therapy;  complex diagnostic imaging services including nuclear medicine, computerized axial tomography (CT scan), cardiac ultrasonography, magnetic resonance imaging (MRI), and arthrography;  complex neurological diagnostic services including electroencephalograms (EEG), electromyogram (EMG) and evoked potential;  complex vascular diagnostic and therapeutic services including Xxxxxx monitoring, treadmill or stress testing, and impedance venous plethysmography;  complex psychological diagnostic testing;  complex pulmonary diagnostic services including pulmonary function testing and apnea monitoring;  hemodialysis and peritoneal renal dialysis;  other Medically Necessary intravenous therapeutic services as approved by HPN, including but not limited to, non-cancer related intravenous injection therapy;  otologic evaluations only for the purpose of obtaining information necessary for evaluation of the need for or appropriate type of medical or surgical treatment for a hearing deficit or a related medical problem;  Positron Emission Tomography (PET) Scans;  therapeutic radiology services; and  treatment of temporomandibular joint disorder. Different Copayment and/or Coinsurance amounts may apply to these Covered Services. Please refer to your Attachment A Benefit Schedule.;

Other Diagnostic and Therapeutic Services. Diagnostic and Therapeutic Covered Services when authorized by a Memberan Insured's PCP Physician and HPNSHL’s Managed Care Program include the following:  anti-cancer drug therapy;  complex allergy diagnostic services including RAST and allergoimmuno therapytherapeutic radiology services;  complex diagnostic imaging services including nuclear medicine, computerized axial tomography (CT scan), cardiac ultrasonography, magnetic resonance imaging (MRI), ) and arthrography;  complex vascular diagnostic and therapeutic services including Xxxxxx monitoring, treadmill or stress testing and impedance venous plethysmography;  complex neurological diagnostic services including electroencephalograms (EEG), electromyogram (EMG) and evoked potential;  complex vascular diagnostic and therapeutic services including Xxxxxx monitoring, treadmill or stress testing, and impedance venous plethysmography;  complex psychological diagnostic testing;  complex pulmonary diagnostic services including pulmonary function testing and apnea monitoring;  anti-cancer drug therapy;  hemodialysis and peritoneal renal dialysis;  other Medically Necessary intravenous therapeutic complex allergy diagnostic services as approved by HPN, including but not limited to, non-cancer related intravenous injection RAST and allergoimmuno therapy;  otologic evaluations only for the purpose of obtaining information necessary for evaluation of the need for or appropriate type of medical or surgical treatment for a hearing deficit or a related medical problem;  treatment of temporomandibular joint disorder;  other Medically Necessary intravenous therapeutic services as approved by SHL, including but not limited to, non-cancer related intravenous injection therapy; and  Positron Emission Tomography (PET) Scans;  therapeutic radiology services; and  treatment of temporomandibular joint disorder. Different Copayment and/or Coinsurance amounts may apply to these Covered Services. Please refer to your Attachment A Benefit Schedule.

Other Diagnostic and Therapeutic Services. Diagnostic and Therapeutic Covered Services when authorized by a Member's PCP and HPN’s Managed Care Program include the following:  anti-cancer drug therapy; Agreement of Coverage  complex allergy diagnostic services including RAST and allergoimmuno therapy;  complex diagnostic imaging services including nuclear medicine, computerized axial tomography (CT scan), cardiac ultrasonography, magnetic resonance imaging (MRI), and arthrography;  complex neurological diagnostic services including electroencephalograms (EEG), electromyogram (EMG) and evoked potential;  complex vascular diagnostic and therapeutic services including Xxxxxx monitoring, treadmill or stress testing, and impedance venous plethysmography;  complex psychological diagnostic testing;  complex pulmonary diagnostic services including pulmonary function testing and apnea monitoring;  hemodialysis and peritoneal renal dialysis;  other Medically Necessary intravenous therapeutic services as approved by HPN, including but not limited to, non-cancer related intravenous injection therapy;  otologic evaluations only for the purpose of obtaining information necessary for evaluation of the need for or appropriate type of medical or surgical treatment for a hearing deficit or a related medical problem;  Positron Emission Tomography (PET) Scans;  therapeutic radiology services; and  treatment of temporomandibular joint disorder. Different Copayment and/or Coinsurance amounts may apply to these Covered Services. Please refer to your Attachment A Benefit Schedule.

Other Diagnostic and Therapeutic Services. Diagnostic and Therapeutic Covered Services when authorized by a Member's PCP and HPN’s Managed Care Program include the following:  anti-cancer drug therapy• therapeutic radiology services;  complex allergy diagnostic services including RAST and allergoimmuno therapy;  • complex diagnostic imaging services including nuclear medicine, computerized axial tomography (CT scan), cardiac ultrasonography, magnetic resonance imaging (MRI), ) and arthrography;  • complex vascular diagnostic and therapeutic services including Xxxxxx monitoring, treadmill or stress testing and impedance venous plethysmography; • complex neurological diagnostic services including electroencephalograms (EEG), electromyogram (EMG) and evoked potential;  complex vascular diagnostic and therapeutic services including Xxxxxx monitoring, treadmill or stress testing, and impedance venous plethysmography;  • complex psychological diagnostic testing;  • complex pulmonary diagnostic services including pulmonary function testing and apnea monitoring;  • anti-cancer drug therapy; • hemodialysis and peritoneal renal dialysis;  other Medically Necessary intravenous therapeutic • complex allergy diagnostic services as approved by HPN, including but not limited to, non-cancer related intravenous injection RAST and allergoimmuno therapy;  • otologic evaluations only for the purpose of obtaining information necessary for evaluation of the need for or appropriate type of medical or surgical treatment for a hearing deficit or a related medical problem;  • treatment of temporomandibular joint disorder; • other Medically Necessary intravenous therapeutic services as approved by HPN, including but not limited to, non-cancer related intravenous injection therapy; and • Positron Emission Tomography (PET) Scans;  therapeutic radiology services; and  treatment of temporomandibular joint disorder. Different Copayment and/or Coinsurance amounts may apply to these Covered Services. Please refer to your Attachment A Benefit Schedule.

Other Diagnostic and Therapeutic Services. Diagnostic and Therapeutic Covered Services when authorized by a Member's PCP and HPN’s Managed Care Program include the following:  anti-cancer drug therapy;  complex allergy diagnostic services including RAST and allergoimmuno therapytherapeutic radiology services;  complex diagnostic imaging services including nuclear medicine, computerized axial tomography (CT scan), cardiac ultrasonography, magnetic resonance imaging (MRI), ) and arthrography;  complex vascular diagnostic and therapeutic services including Xxxxxx monitoring, treadmill or stress testing and impedance venous plethysmography;  complex neurological diagnostic services including electroencephalograms (EEG), electromyogram (EMG) and evoked potential;  complex vascular diagnostic and therapeutic services including Xxxxxx monitoring, treadmill or stress testing, and impedance venous plethysmography;  complex psychological diagnostic testing;  complex pulmonary diagnostic services including pulmonary function testing and apnea monitoring;  anti-cancer drug therapy;  hemodialysis and peritoneal renal dialysis;  other Medically Necessary intravenous therapeutic complex allergy diagnostic services as approved by HPN, including but not limited to, non-cancer related intravenous injection RAST and allergoimmuno therapy;  otologic evaluations only for the purpose of obtaining information necessary for evaluation of the need for or appropriate type of medical or surgical treatment for a hearing deficit or a related medical problem;  treatment of temporomandibular joint disorder;  other Medically Necessary intravenous therapeutic services as approved by HPN, including but not limited to, non-cancer related intravenous injection therapy; and  Positron Emission Tomography (PET) Scans;  therapeutic radiology services; and  treatment of temporomandibular joint disorder. Different Copayment and/or Coinsurance amounts may apply to these Covered Services. Please refer to your Attachment A Benefit Schedule.