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Humana Medical Policy Updates – September 2018
Click here to view the Humana Medical Policy Updates Updates »
September 2018 Humana Medical Policy Updates;
- Acupuncture
- Appropriate Site of Care for Injectable Drugs
- Attention Deficit Hyperactivity Disorder (ADHD) – Diagnosis and Treatment
- Autism Spectrum Disorders (ASD) Diagnosis and Treatment
- Benign Skin Lesion Treatments
- Chiropractic Care
- Complementary and Alternative Medicine (CAM)
- Continuous Ambulatory Blood Pressure Monitoring
- Copaxone® (glatiramer)
- Cosmetic Surgery, Reconstructive Surgery, Scar Revision
- Dynamic Spinal Stabilization Devices
- Electrical Stimulators – Diaphragmatic/Phrenic Nerve, Functional and Neuromuscular
- Genetic Testing for Cardiac Conditions
- Genetic Testing for Cystic Fibrosis
- Genetic Testing for Disease Risk
- High Risk Medications (HRM) in the Elderly
- Home Health
- Immunoassay Testing for Rupture of Membranes (ROM) in Pregnancy
- Intrauterine Fetal Surgery
- Obstructive Sleep Apnea (OSA) and Other Sleep Related Breathing Disorders Nonsurgical Treatments
- Obstructive Sleep Apnea (OSA) Surgical Treatments
- Percutaneous Vertebroplasty, Kyphoplasty (Balloon-Assisted Vertebroplasty), Sacroplasty
- Pharmacogenomics – Cytochrome P450 Polymorphisms and VKORC1
- Plantar Fasciitis Treatments
- Proton and Neutron Beam Radiation Therapy
- Small Fiber Neuropathy Diagnostic Testing
- Torisel® (temsirolimus)
- Ultraviolet Light/Laser Therapy for Skin Conditions
- Ventricular Assist Device (VAD), Total Artificial Heart (TAH)
- Vertebral Decompression Therapy
Added 9/21/2018;
- Adcetris® (brentuximab vedotin)
- Adcirca® (tadalafil)
- Adcirca® (tadalafil)
- Besponsa™ (inotuzumab ozogamicin)
- Botox® (Botulinum Toxin)
- Complementary and Alternative Medicine (CAM)
- Continuous Glucose Monitoring Systems
- Cosmetic Surgery, Reconstructive Surgery, Scar Revision
- Cosmetic Surgery, Reconstructive Surgery, Scar Revision
- Cosmetic Surgery, Reconstructive Surgery, Scar Revision
- Crotan (crotamiton)
- Differin® (adapalene) and Epiduo® (adapalene and benzoyl peroxide)
- DUOPA® (carbidopa and levodopa enteral suspension)
- Durable Medical Equipment (DME)
- Epoetin alfa (Procrit®, Epogen®, Retacrit™)
- Faslodex® (fulvestrant)
- Fetzima® (levomilnacipran)
- Fulphila™ (pegfilgrastim‐jmdb)
- Genetic Testing for Disease Risk
- Istodax® (romidepsin)
- Kisqali® (ribociclib)
- Korlym® (mifepristone)
- Lidoderm® (lidocaine 5% patch)
- Livalo® (pitavastatin)
- Macrilen™ (macimorelin)
- Ninlaro® (ixazomib)
- Nuedexta® (dextromethorphan and quinidine)
- Opdivo® (nivolumab)
- Oral Acne Antibiotics
- Orkambi® (lumacaftor/ivacaftor)
- Potassium Binding Agents
- Preimplantation Genetic Testing
- Relistor® (methylnaltrexone bromide)
- Remicade Biosimilars
- Remicade Biosimilars
- Retisert® (fluocinolone acetonide intravitreal implant)
- Sandostatin® S.C., Sandostatin LAR® Depot (octreotide acetate for injection)
- Sandostatin® S.C., Sandostatin LAR® Depot (octreotide acetate for injection)
- Signifor® (pasireotide)
- Signifor® LAR (pasireotide)
- Synera® (lidocaine and tetracaine) topical patch
- Tobramycin for Inhalation
- Tobramycin for Inhalation
- Vytorin® (ezetimibe/simvastatin)
- Xtandi® (enzalutamide)
- Xtandi® (enzalutamide)
- Zyclara® (imiquimod)
- Zyflo® (zileuton) and Zyflo CR® (zileuton extended release)
Added 9/27/2018;
- Ablation Techniques and Extracorporeal Shock Wave Therapy for Musculoskeletal Indications and Soft Tissue Wounds
- Abraxane® (nab‐paclitaxel)
- Actinic Keratoses Treatments
- Antipsychotic Utilization Program
- Aranesp (darbepoetin alfa)
- Aranesp® (darbepoetin alfa)
- Aveed® (testosterone undecanoate)
- Benzodiazepine Limited Days’ Supply
- Berinert (C1 esterase inhibitor, human)
- Besponsa™ (inotuzumab ozogamicin)
- Boniva® and generic ibandronate sodium Injection
- Botox® (Botulinum Toxin)
- Brachytherapy
- Breast Reconstruction
- Capsule Endoscopy
- Cardiac Monitoring Devices
- Cardiac Rehabilitation
- Chronic Vertigo Evaluation and Treatments
- Clinical Trials
- Cold Therapy Devices/Heating Devices/Combined Heat and Cold Therapy Devices
- Complementary and Alternative Medicine (CAM)
- Corlanor® (ivabradine)
- Diagnostic Esophagogastroduodenoscopy (EGD) or Esophagoscopy (age 59 years or younger)
- Doptelet® (Avatrombopag)
- Drug Testing
- Electrothermal Intradiscal Therapies
- Entyvio® (vedolizumab)
- Entyvio® (vedolizumab)
- Epoetin alfa (Procrit®, Epogen®, Retacrit™)
- Eylea® (aflibercept)
- Faslodex® (fulvestrant)
- Faslodex® (fulvestrant)
- Firazyr (icatibant)
- Flector Patch® (diclofenac epolamine patch 1.3%)
- Fulphila™ (pegfilgrastim‐jmdb)
- Galafold™(migalastat)
- Gene Expression Profiling
- Genetic Testing for Cardiac Conditions
- Genetic Testing for Carrier Screening
- Genetic Testing for Diagnosis and Monitoring – Noncancer Indications
- Genetic Testing for Diagnosis and Monitoring – Noncancer Indications
- Genetic Testing for Disease Risk
- Genetic Testing for Inherited Thrombophilias
- Immunoassay Testing for Rupture of Membranes
- Inflectra (infliximab‐dyyb)
- Inflectra (infliximab‐dyyb)
- Intraocular Lens (IOL) Implants
- Istodax® (romidepsin)
- Jevtana® (cabazitaxel)
- Joint Resurfacing Arthroplasty
- Kalbitor (ecallantide)
- Kalydeco® (ivacaftor)
- Kisqali® (ribociclib)
- Left Atrial Appendage and Cardiac Structural Defect Closure for Stroke Prevention
- Liquid Biopsy
- Lucemyra® (lofexidine)
- Lucentis® (ranibizumab)
- Lung Cancer Screening
- Macugen® (pegaptanib octasodium)
- Micera (methoxy polyethylene glycol‐epoetin beta)
- Microwave Thermotherapy
- Mircera® (methoxy polyethylene glycol‐epoetin beta)
- Molecular Diagnostic Testing for Reproductive Health
- Multianalyte Assays with Algorithmic Analyses (MAAAs)
- Nuplazid™ (pimavanserin)
- Opdivo® (nivolumab)
- Opioid Days’ Supply Limitation
- Opioid Utilization Program ‐ Morphine Equivalent Dose (MED) edits
- Orencia (abatacept) Intravenous
- Parsabiv® (etelcalcetide)
- Pharmacogenomics – Cytochrome P450 Polymorphisms and VKORC1
- Pharmacogenomics – Cytochrome P450 Polymorphisms and VKORC1
- Physical Therapy and Occupational Therapy
- Radiofrequency Tumor Ablation
- Relistor® (methylnaltrexone)
- Renflexis (infliximab‐abda)
- Renflexis (infliximab‐abda)
- Spinal Decompression Surgery
- Thyroid Surgeries (Thyroidectomy & Lobectomy)
- Topical Doxepin Products (doxepin, Prudoxin, Zonalon®)
- Tysabri® (natalizumab)
- Tysabri® (natalizumab)
- Videofluoroscopy, Dynamic MRI for Musculoskeletal Indications
- Viscosupplements (Durolane®, Euflexxa®, Gel‐One®, Gelsyn‐3™, GenVisc® 850, Hyalgan®, Hymovis®, Supartz™, Supartz FX™, Synvisc®, Synvisc‐One®, Visco‐3™)
- Visudyne® (verteporfin)
- Zilretta™ (triamcinolone acetonide extended‐release injectable suspension)
Click here to view the Humana Medical Policy Updates Updates »
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