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Humana Medical Policy Updates – December 2022
Click here to view the Humana Medical Policy Updates Updates »
December 2022 Humana Medical Policy Updates:
- Abecma® (idecabtagene vicleucel)
- Accrufer™ (ferric maltol)
- Acupuncture
- Adakveo® (crizanlizumab-tmca)
- Allergy Ophthalmics
- Allergy Ophthalmics
- Alunbrig™ (brigatinib)
- Ambulatory Cardiac Monitoring Devices
- Aptiom® (eslicarbazepine acetate) tablets
- Artificial Intervertebral Disc Replacement
- Atgam® (antithymocyte immune globulin, equine)
- Autism Spectrum Disorders Diagnosis and Treatment
- Autonomic Nerve Function Testing
- Bariatric Surgery
- Bendamustine products (Treanda, Bendeka, Belrapzo, Vivimusta)
- Biofeedback
- Bone Density Measurement
- Brachytherapy
- Brimonidine-timolol eye drops (generic Combigan)
- Buprenorphine transdermal patch
- Caprelsa® (vandetanib)
- Capsule Endoscopy
- Carbinoxamine 6mg tablet
- Cardiac Catheterization
- Cardioverter Defibrillators/Cardiac Resynchronization Therapy
- Cimzia® (certolizumab pegol)
- Coagadex® (Coagulation Factor X [Human])
- Code Compendium (Cardiovascular)
- Code Compendium (Miscellaneous)
- Code Compendium (Musculoskeletal and Neurologic)
- Code Compendium (Wound Care)
- Colorectal Cancer Screening and Surveillance
- Comprehensive Molecular Profiling for Hematologic Malignancies and Solid Tumors
- Continuous Glucose Monitoring Systems and Insulin Pumps
- Corifact® (Factor XIII Concentrate [Human])
- Cryoablation
- Cyklokapron® (tranexamic acid)
- Danyelza® (naxitamab-gqgk)
- Deep Brain Stimulation and Cortical Brain Stimulation
- Deferasirox Products
- Digital Therapeutics
- Doptelet® (Avatrombopag)
- Duexis® (ibuprofen-famotidine)
- Duexis® (ibuprofen-famotidine) tablet
- Electrical Stimulators for Pain and Nausea/Vomiting
- Electrothermal Intradiscal Therapies
- Emend® Oral (aprepitant)
- Empaveli™ (pegcetacoplan)
- Endari™ (L-glutamine)
- Enjaymo™ (sutimlimab-jome)
- Erivedge® (vismodegib)
- Extended Ophthalmoscopy
- Factor IX Replacement Products (Hemophilia B)
- Factor VIII Replacement Products (Hemophilia A)
- Fecal Incontinence Evaluation and Treatments
- Fecal Microbiota Transplantation
- FEIBA NF (Anti-Inhibitor Coagulant Complex)
- Ferriprox® (deferiprone)
- Florida Statute 456.44(5)(a) Opioid Days’ Supply Limitation
- Furoscix® (furosemide)
- Fyarro (sirolimus protein-bound particles for injectable suspension)
- Gastric Pacing
- Gastrointestinal Motility Monitoring
- Gavreto™ (pralsetinib)
- Gene Expression Profiling
- Genetic and Biomarker Testing for Alzheimer Disease
- Genetic Testing for Carrier Screening
- Genetic Testing for Diagnosis of Noncancer Indications
- Genetic Testing for Disease Risk
- Genetic Testing for Niemann-Pick Disease
- Givlaari® (givosiran) subcutaneous injection
- Gloperba® (colchicine) Oral Solution
- Gloperba® (colchicine) Oral solution
- Gralise® (gabapentin)
- Headache and Occipital Neuralgia Treatments
- Hemlibra® (emicizumab-kxwh)
- Hip, Knee and Shoulder Arthroscopic Surgeries
- Horizant® (gabapentin enacarbil)
- Implantable Hearing Devices
- Inhaled Nitric Oxide
- Laboratory Analysis for Prostate Cancer
- Lamotrigine Products
- Lidocaine 5% topical ointment
- Lidocaine 5% topical patch
- Lidoderm (lidocaine patch 5%)
- Limited Day Supply
- Low Level Laser and High Power Laser Therapy
- Lupron® (leuprolide acetate) and Generic Depot Products
- Lybalvi™ (olanzapine and samidorphan)
- Lyrica® (pregabalin)
- Lyrica® CR (pregabalin)
- Megace® ES (megestrol acetate)
- Molecular Diagnostic Testing for Lyme Disease and other Vector Borne Illness
- Molecular Markers in Fine Needle Aspirates of Thyroid Nodules
- Mulpleta® (lusutrombopag)
- Multiplex Pathogen Testing and Next Generation Sequencing for Infectious Disease
- Myalept® (metreleptin)
- Myalept® (metreleptin)
- Nascobal® (cyanocobalamin)
- Noninvasive Prenatal Testing
- Nonsteroidal Anti-Inflammatory Drug Products
- NovoSeven® RT (Coagulation Factor VIIa [Recombinant])
- Noxafil® (posaconazole)
- Nplate® (romiplastim)
- NSAID Combination Products
- Obizur [antihemophilic (recombinant), porcine sequence]
- Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Surgical Treatments
- Ocular Surface Disease Diagnosis and Treatments
- Odomzo® (sonidegib)
- Ophthalmic Antibiotics
- Ophthalmic Antibiotics
- Ophthalmic Non-Steroidal Anti-Inflammatory Drugs
- Ophthalmic Non-Steroidal Anti-Inflammatory Drugs
- Ophthalmic Steroids
- Ophthalmic Steroids
- Opioid Utilization Program – Morphine Milligram Equivalents (MME) edits
- Orphenadrine Products
- Osteochondral and Subchondral Defects Surgery
- Oxaydo® (oxycodone HCL)
- Oxbryta™ (voxelotor)
- Oxtellar XR® (oxcarbazepine) extended-release tablet
- Palforzia™ (peanut allergen powder)
- Pedmark ® (sodium thiosulfate injection)
- Pennsaid® (diclofenac topical solution)
- Percutaneous Vertebroplasty, Kyphoplasty, Sacroplasty
- Peripheral Artery Angiography, Rehabilitation, Revascularization and Screening – Lower Extremities
- Pharmacogenomics – Noncancer Indications
- Pharmacogenomics and Companion Diagnostics
- Pheburane® (sodium phenylbutyrate) oral pellets
- Probuphine® (buprenorphine) Implant
- Promacta® (eltrombopag)
- Prostatectomy
- Proton Beam, Neutron Beam and Carbon Ion Radiation Therapy
- Qudexy XR®, Trokendi XR® (topiramate) extended-release capsules
- Reblozyl® (luspatercept-aamt)
- Relistor® (methylnaltrexone)
- Rhinoplasty-Septoplasty
- Rhopressa® (netarsudil)
- Rhopressa® (netarsudil), Rocklatan® (netarsudil and latanoprost)
- Ryplazim® (plasminogen, human-tvmh)
- Sabril® (vigabatrin)
- Sancuso (granisetron) Transdermal
- Savella® (milnacipran)
- Seglentis® (celecoxib-tramadol)
- Siklos® (hydroxyurea)
- Skin and Tissue Substitutes
- Skin Lesion Surveillance Technologies
- Skysona (elivaldogene autotemcel)
- Speech Therapy
- Spinal Cord Stimulators
- Spinal Decompression Surgery
- Spinal Fusion Surgery
- Sprix® (ketorolac tromethamine) nasal spray
- Sublocade™ (buprenorphine extended-release) injection
- Sustol® (granisetron)
- Susvimo™ (ranibizumab)
- Taltz® (ixekizumab)
- Tavalisse® (fostamatinib)
- Tavneos™ (avacopan)
- Temporomandibular Joint Disorders
- Tepezza™ (teprotumumab)
- Thrombate III® [Antithrombin III (Human)]
- Thyroid Surgeries (Thyroidectomy and Lobectomy)
- Tretten® (Coagulation Factor XIII A-Subunit [Recombinant])
- Urinary Bladder Dysfunction
- Vagus Nerve Stimulation
- Ventricular Assist Device Total Artificial Heart
- Vigabatrin products
- Viscosupplements
- Viscosupplements
- Viscosupplements – Multi Injection
- Viscosupplements – Single Injection
- Visudyne® (verteporfin)
- Voltaren® Gel (diclofenac)
- Von Willebrand Factor Replacement Products
- Xenical® (orlistat)
- Xipere™ (triamcinolone acetonide)
- ZTlido® (lidocaine topical system)
- ZTlido™ (lidocaine topical system)
- Zuplenz® (ondansetron oral soluble film)
- Zynteglo (betibeglogene autotemcel)
- Zypitamag® (pitavastatin)
- Zypitamag™ (pitavastatin)
Click here to view the Humana Medical Policy Updates Updates »
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