Triad Healthcare, Inc.'s medical policies are designed to properly address real-world medical scenarios within allied specialty healthcare. Our adherence to medical necessity permeates the manner in which we encourage providers to administer care.

Current Medical Policies

Please click here to download a .zip file containing all of our current medical policies.

Please click the links below to open or save our individually listed, current medical policies:

• TRIAD NON SPINAL RELATED DIAGNOSIS LIST
• TRIAD SPINAL RELATED DIAGNOSIS LIST
• TMMP 1 - Patient Under Twelve Years of Age
• TMMP 2 - Severity Adjusting Reported Conditions/Diagnoses
• TMMP 3 - Frequency of Care
• TMMP 10 - Intensity of Care
• TMMP 11 - Necessity for Regional Application of Chiropractic Manipulative Treatment
• TMMP 12 - Spinal CMT with Concurrent Non-Spinal / Extra-Spinal CMT
• TMMP 13 - Convergent Modalities and/or Therapeutic Procedure
• TMMP 14 - Redundant Modalities and/or Therapeutic Procedure
• TMMP 15 - Minimal Clinical Progress
• TMMP 16 - Definition of Established Services.
• TMMP 17 - Contraindications to Care
• TMMP 18 - Medical Necessity Policy
• TMMP 19 - Evaluation and Management Services (New Patient)
• TMMP 20 - Evaluation and Management Services (Established Patient)
• TMMP 21 - Concurrent Evaluation and Management Services
• TMMP 23 - Therapeutic Care Policy
• TMMP 24 - Criteria for Determining Consideration of Medically Necessary Services
• TMMP 25 - Electrodiagnosis
• TMMP 26 - Durable Medical Equipment
• TMMP 28 - Neuromusculoskeletal Policy
• TMMP 29 -Radiology
• TMMP 31 - Coding and Reporting Chiropractic Manipulative Treatment
• TMMP 32 - Exploratory or Confirmatory Diagnostic Evaluation Policy
• TMMP 33 - Clinical Judgment
• TMMP 34 - Billing for Family-Staff Members policy
• TMMP 35 - Treatment of Family-Staff Members policy
• TMMP 36 - Scoliosis
• TMMP 37 - Quality of Care Issues
• TMMP 57 - Transitional Care
• TMMP 58 - Identification and Referral of Case Management to Plan

Changes to Medical Policies to be Implemented on September 8, 2008

• Obsolete: TRIAD NON SPINAL RELATED DIAGNOSIS LIST
• Obsolete: TRIAD SPINAL RELATED DIAGNOSIS LIST
• Obsolete: TMMP 1 - Patient Under Twelve Years of Age
• Obsolete: TMMP 13 - Convergent Modalities and/or Therapeutic Procedure
• Obsolete: TMMP 14 - Redundant Modalities and/or Therapeutic Procedure
• Obsolete: TMMP 16 - Definition of Established Services.
• Obsolete: TMMP 23 - Therapeutic Care Policy
• Obsolete: TMMP 24 - Criteria for Determining Consideration of Medically Necessary Services
• Obsolete: TMMP 28 - Neuromusculoskeletal Policy
• Obsolete: TMMP 33 - Clinical Judgment
• Obsolete: TMMP 35 - Treatment of Family-Staff Members Policy
• Revised: TMMP 2 - Conditions/Diagnoses of Severity Adjusting (New Title) (Old Title: Severity Adjusting Reported Conditions/Diagnosis)
• Revised: TMMP 3 - Frequency of Care
• Revised: TMMP 10 - Use of Physical Medical Modalities and Therapeutic Procedures (New Title) (Old Title: Intensity of Care)
• Revised: TMMP 11 - Use of Spinal Mobilization/Manipulation (New Title) (Old Title: Necessity for Regional Application of Chiropractic Manipulative Treatment)
• Revised: TMMP 12 - Use of Non-Spinal/Extremity Mobilization/Manipulation (New Title) (Old Title: Spinal CMT with Concurrent Non-Spinal/Extra-Spinal CMT)
• Revised: TMMP 15 - Minimal Clinical Progress
• Revised: TMMP 17 - Contraindications to Care
• Revised: TMMP 18 - Medical Necessity Policy
• Revised: TMMP 19 - Evaluation and Management Services (New Patient)
• Revised: TMMP 20 - Evaluation and Management Services (Established Patient)
• Revised: TMMP 21 - Concurrent Evaluation and Management Services
• Revised: TMMP 25 - Use of Electrodiagnosis Testing (New Title) (Old Title: Electrodiagnosis)
• Revised: TMMP 26 - Durable Medical Equipment
• Revised: TMMP 29 - Use of Radiographic Examinations (New Title) (Old Title: Radiology)
• Revised: TMMP 31 - Coding and Reporting Chiropractic Manipulative Treatment
• Revised: TMMP 32 - Exploratory or Confirmatory Diagnostic Evaluation Policy
• Revised: TMMP 34 - Billing for Family-Staff Members
• Revised: TMMP 36 - Treatment of Asymptomatic Abnormal Spinal Curvatures (New Title) (Old Title: Scoliosis)
• Revised: TMMP 37 - Quality of Care Issues
• Revised: TMMP 57 - Transitional Care
• Revised: TMMP 58 - Identification and Referral of Case Management to Plan

Archived Policies

Functionality: