This Clinical Policy Bulletin (CPB) supplements but does not replace, modify, or supersede existing Medicare Regulations or applicable National Coverage Determinations (NCDs) or Local Coverage Determinations (LCDs). The supplemental medical necessity criteria in this CPB further define those indications fo...
Aetna considers continuation of brolucizumab-dbll (Beovu) therapy medically necessary for members requesting reauthorization for an indication listed in Section I when the member has demonstrated a positive clinical response to therapy (e.g., improvement or maintenance in best corrected visual acuity [...
Since surgery to correct a condition of "moon face" which developed as a side effect of cortisone therapy does not meet the exception to the exclusion, it is not covered under Medicare (§1862(a)(10) of the Act). An UpToDate review on “Overview of breast disorders in children and adole...
This Clinical Policy Bulletin addresses gonadotropin-releasing hormone analogs and antagonists for commercial medical plans. For Medicare criteria, seeMedicare Part B Criteria. Note: Requires Precertification: For the prostate cancer indication only, precertification of gonadotropin-releasing hormone products (...
This Clinical Policy Bulletin (CPB) supplements but does not replace, modify, or supersede existing Medicare Regulations or applicable National Coverage Determinations (NCDs) or Local Coverage Determinations (LCDs). The supplemental medical necessity criteria in this CPB further define those indications fo...
This Clinical Policy Bulletin addresses growth hormone (GH) and growth hormone antagonists for commercial medical plans. For Medicare criteria, seeMedicare Part B Criteria. Note: Requires Precertification: Precertification of Somavert is required of all Aetna participating providers and members in applicab...
Centers for Medicare & Medicaid Services (CMS), Medicare Coverage Database [Internet]. Baltimore, MD: CMS; updated periodically. Available at: Medicare Coverage Center. Accessed November 7, 2023. Related Policies CPB 0016 - Back Pain - Invasive Procedures CPB 0743 - Spinal Surgery: Laminectomy an...
This Clinical Policy Bulletin (CPB) supplements but does not replace, modify, or supersede existing Medicare Regulations or applicable National Coverage Determinations (NCDs) or Local Coverage Determinations (LCDs). The supplemental medical necessity criteria in this CPB further define those indications fo...
Most of the supplements failed to show beneficial effects for CFS, with the exception of NADH and magnesium. The authors concluded that the results of this systematic review provided limited evidence for the effectiveness of CAM therapy in relieving symptoms of CFS. However, the authors were not ...
Montgomery GK. A multi-factorial account of disability after brain injury: Implications for neuropsychological counseling. Brain Inj. 1995;9(5):453-469. National Heritage Insurance Company (NHIC). Neuropsychological testing. Medicare Part B Local Medical Review Policy. Policy No. 02-812-R3. Hingham...