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ACG
​
h.o.l.M.E.S.

Automated Clinical Guidelines

Hip

Core Decompression for Avascular Necrosis
Distraction Osteosynthesis and Femoral Shortening
Femero-Acetabular Surgery for Hip Impingment Syndrome
Hip Arthroscopy
Hip Surgery-Arthroscopic and Open Procedures
Functional Status Assessment for Total Hip Replacement (CMS56v10)
Hip, Total (THA) 
Aetna
FloridaBlue
Anthem
Aetna
Aetna
Humana
Cigna
Aetna
Anthem
UHC
UHC
FloridaBlue
Cigna
Humana
Medicare
Hip Surgery
Hip Resurfacing
Ilizarov method of distraction osteosynthesis
Outpatient Total Knee and Total Hip Arthroplasty
Point32Health
Anthem
Aetna
Anthem

Indicates Non-covered Service

Athletic Pubalgia Surgery
Computer-Assisted Navigation for Orthopedic Procedures
Orthopedic Applications of Stem-Cell Therapy

Visco-

supplements

Aetna
Humana
Cigna
FloridaBlue
FloridaBlue
FloridaBlue
UHC

27120, 27125, 27130, 27132, 27134, 27137, 27138, 27299, 29860, 29861, 29862, 29863, 29914, 29915, 29916, 29999, S2118

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