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For the treatment of PsA, member has a contraindication, intolerance or ineffective response to all of the following available equivalent alternative targeted immune modulators (one-month trial each): Simponi Aria, Stelara, and Avsola or Inflectra Chronic Severe Plaque Psoriasis For the treatment of c...
I didn't list my primary care provider, so I was given one, but Aetna Better Health helped me easily switch to my doctor. I have hypertension, and I have to see the doctor every few months just to make sure things are under control. I don't own a car, and the cost of transp...
The infusion pump has been approved by the U.S. Food and Drug Administration (FDA) for infusion of the particular drug that is to be administered; Intrathecal pump for baclofen (e.g. Gablofen, Lioresal) therapy An intrathecal pump for baclofen therapy is considered medically necessary for t...
According to the Society for Maternal-Fetal Medicine (SMFM, 2013), when a choroid plexus cyst is identified, the presence of structural malformations and other sonographic markers of aneuploidy should be assessed with a detailed fetal anatomic survey performed by an experienced provider. Detailed ...
Vescovi and Nammour (2010) stated that BRONJ is an area of uncovered bone in the maxillo-facial region that did not heal within 8 weeks after identification by health care provider, in a patient who was receiving or had been exposed to BP therapy (BPT) without previous radiation therapy to...
Patients who have questions should talk to their healthcare provider. Approvals of these drugs have been withdrawn because the drugs are no longer shown to be effective and the benefits do not outweigh the risks for the indication for which they were approved" (FDA, 2023). Medroxyprogesterone...
collected via a parent/caregiver facing app, a questionnaire completed by a video analyst who reviews parent/caregiver recorded videos of the child, and a healthcare provider questionnaire completed by a physician during child and parent/caregiver interaction via a healthcare provider portal. A...
The provider will be notified of the coverage decision after review of all pertinent data. Diagnostic Testing Aetna considers the following medically necessary for diagnostic testing for TMJ/TMD using the following modalities: Examination including a history, physical examination, muscle testing, range ...