which are < 140/90. • The member has no evidence of end-organ damage. Li mi t at i ons • Tufts Health Plan does not cover ambulatory blood pressure monitoring for routine diagnosis and/or follow-up of previously diagnosed hypertension. • Tufts Health Plan does not cover home blood...
Medical Necessity Guidelines: Breast PumpsICD-10 CodeQ36.9Q37.0Q37.1Q37.2Q37.3Q37.4Q37.5Q37.8Q37.9Q38.0Q38.2Q38.3Q38.4Q38.6Q38.7Q38.8Effective: OctoberNot CoveredPrior Authorization Required