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ACG
​
h.o.l.M.E.S.

Automated Clinical Guidelines

Ankle/Foot

FloridaBlue
Allograft Transplants of Ankle
Anthem
Medicare
Aetna
Cigna
FloridaBlue
Humana
Medicare
Cigna
Ankle Arthritis Surgery
Ankle Arthroscopy
UHC
Ankle Arthrotomy
UHC
Total Ankle Arthroplasty
UHC
Aetna
Arthrodesis or Arthroplasty, Interphalangeal Joint, Second-Fifth Toes
UHC
Anthem
Bunionectomy (hallux valgus surgery)
Humana
Bunion Surgery
Aetna
Debridement of Mycotic Nails
EpiFix Wound Treatment
First Toe Osteotomy of the Proximal Phalanx
UHC
Hammertoe Repair
Aetna
Metatarsal Phalangeal Joint Replacement
Aetna
Nail Debridement
Surgical Treatment of Nails
Humana
Plantar Fascial Release
Aetna
UHC
Surgical Treatment of Tailor's Bunion or Bunionette
UHC
Medicare
Routine Foot Care
Tibial Nerve Decompression

Indicates Non-covered Service

Articular Cartilage Repair of the Ankle
Cigna
Aetna
Gait Analysis & Electrodyno-gram
Treatment of Ulcers and Symtomatic Hyperkeratoses
Aetna
Extraosseous Subtalar Joint Implantation and Subtalar Arthroereisis
Extracorporeal Shock Wave Therapy for Musculoskeletal Conditions
Functional Neuromuscular  Stimulation
Minimally Invasive Treatments for Plantar Fasciitis
Cigna
FloridaBlue
Noncontact Normothermic Wound Therapy
FloridaBlue
Orthopedic Applications of Stem-Cell Therapy
Aetna
Pedobar-ography
Aetna
Quantitative Sensory Testing
FloridaBlue
Subtalar Arthroereisis
Cigna
FloridaBlue
Humana

26535, 26536, 27685, 27700, 27702, 27703, 27704, 28110, 28240, 28285, 28289, 28291, 28292, 28295, 28296, 28298, 28299, 28306, 28308, 28310, 28740, 28750, 28899, 29891, 29892, 29893, 29894, 29895, 29897, 29898, 29899

Achilles Tendon Repair
UHC
Ankle Arthrodesis (Talotibial Joint)
UHC
First Metatarsophalangeal (MTP) Joint Arthrodesis
UHC
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