TRICARE Policy Manual 6010.60-M, April 1, 2015 Chapter 4 Surgery Revision: C-30, August 15, 2018 Section/Addendum Subject/Addendum Title 1.1 Complications (Unfortunate Sequelae) Resulting From Noncovered Surgery Or Treatment 1.2 Treatment Of Unfortunate Sequelae And/Or Medically Necessary Follow-On Care Subsequent To Authorized Noncovered Initial Surgery Or Treatment In A Military Treatment Facility (MTF)/Enhanced Multi-Service Market (eMSM) 2.1 Cosmetic, Reconstructive, And Plastic Surgery - General Guidelines 2.2 General Surgery 3.1 Laser Surgery 3.2 Robotic Surgery 4.1 Assistant Surgeons 5.1 Integumentary System 5.2 Post-Mastectomy Reconstructive Breast Surgery and Breast Prostheses 5.3 Prophylactic Mastectomy, Prophylactic Oophorectomy, And Prophylactic Hysterectomy 5.4 Reduction Mammaplasty For Macromastia 5.5 Silicone Or Saline Breast Implant Removal 5.6 Breast Reconstruction As A Result Of A Congenital Anomaly 5.7 Gynecomastia 5.8 Negative Pressure Wound Therapy (NPWT) 6.1 Musculoskeletal System 6.2 Bone Growth Stimulation 7.1 Oral Surgery 8.1 Respiratory System 8.2 Lung Volume Reduction Surgery (LVRS) 9.1 Cardiovascular System 9.2 Photopheresis 9.3 Intracoronary Stents 9.4 Therapeutic Apheresis 10.1 Transjugular Intrahepatic Portosystemic Shunt (TIPS) 11.1 Hemic And Lymphatic Systems 12.1 Mediastinum And Diaphragm 13.1 Digestive System 13.2 Surgery For Morbid Obesity 14.1 Urinary System 15.1 Male Genital System 16.1 Intersex Surgery 17.1 Female Genital System 18.1 Maternity Care 18.2 Antepartum Services 18.3 Abortions 18.4 Cesarean Sections 18.5 Fetal Surgery 19.1 Endocrine System 20.1 Nervous System 20.2 Stereotactic Radiofrequency Pallidotomy With Microelectrode Mapping For Treatment Of Parkinson’s Disease 20.3 Stereotactic Radiofrequency Thalamotomy 21.1 Eye And Ocular Adnexa 22.1 Auditory System 22.2 Cochlear Implantation 23.1 High Dose Chemotherapy (HDC) And Stem Cell Transplantation 24.1 Heart-Lung And Lung Transplantation 24.2 Heart Transplantation 24.3 Combined Heart-Kidney Transplantation (CHKT) 24.4 Small Intestine (SI), Combined Small Intestine-Liver (SI/L), And Multivisceral Transplantation 24.5 Liver Transplantation 24.6 Combined Liver-Kidney Transplantation (CLKT) 24.7 Simultaneous Pancreas-Kidney (SPK), Pancreas-After-Kidney (PAK), And Pancreas-Transplant-Alone (PTA), And Pancreatic Islet Cell Transplantation 24.8 Kidney Transplantation 24.9 Donor Costs