![]() ![]() The following services are excluded from coverage regardless of clinical indications: Macromastia or Gynecomastia Surgeries Abdominoplasty Panniculectomy Redundant skin surgery Removal of skin tags Acupressure Dance therapy, movement therapy Applied kinesiology Rolfing Prolotherapy and Extracorporeal shock wave lithotripsy (ESWL) for musculoskeletal and orthopedic conditions. The following services are excluded from coverage regardless of clinical indications Rhinoplasty Blepharoplasty Redundant skin surgery Removal of skin tags Acupressure Craniosacral/cranial therapy Dance therapy, movement therapy Applied kinesiology Rolfing Prolotherapy and Extracorporeal shock wave lithotripsy (ESWL) for musculoskeletal and orthopedic conditions. The following services are excluded from coverage regardless of clinical indications: Macromastia or Gynecomastia Surgeries Abdominoplasty Panniculectomy Rhinoplasty Blepharoplasty for cosmetic reasons Redundant skin surgery Removal of skin tags for cosmetic reasons Acupressure Craniosacral/cranial therapy Dance therapy, Movement therapy Applied kinesiology Rolfing Prolotherapy and Extracorporeal shock wave lithotripsy (ESWL) for musculoskeletal and orthopedic conditions.
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