Molecular Diagnostic Testing for Hematology and Oncology ...

General Criteria for Somatic Mutation Genetic Testing ... initiate a related therapy and the therapy has been validated by the National Comprehensive Cancer Network™ (NCCN Guidelines™) as a category 1, 2A, or 2B recommendation for the ... Detection of circulating whole tumor cells for any other indication is considered experimental,

  Detection, Validated, Mutation

Bariatric Surgery and Procedures - Cigna

This Coverage Policy addresses bariatric surgery and procedures for the treatment of morbid obesity. Coverage Policy . Coverage for bariatric surgery or revision of a bariatric surgery procedure varies across plans and may be governed by state mandates. Refer to the customer’s benefit plan document for coverage details.

  Surgery, Bariatric, Bariatric surgery

Anesthesia Services for Interventional Pain Management ...

Monitored anesthesia care (MAC) is a service rendered by an anesthesia practitioner (i.e., anesthesiologist, certified registered nurse anesthetist CRNA]) who is not involved in the diagnostic or procedural service being performed. The ASA defines MAC as

  Services, Management, Pain, Anesthesia, Interventional, Monitored, Monitored anesthesia, Anesthesia services for interventional pain management

REVENUE CODE LIST-CPT-HCPCS - Cigna

REVENUE CODE LIST-CPT-HCPCS For Providers Effective March 15, 2020 . All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, includingCigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Cigna Behavioral Health, Inc., and HMO or service

  Code, Revenue, Revenue codes

Minimally Invasive Spine Surgery Procedures and Trigger ...

Trigger Point: Trigger point injection therapy involves the injection of anesthetic or corticosteroids into distinct, focal hyper-irritable spots (i.e., trigger points) located in a tight band of skeletal muscle. Myofascial pain syndrome is a chronic form of muscle pain centered near trigger points.

  Triggers

Diabetes Equipment and Supplies

• hypoglycemic wristband alarm (e.g., Diabetes Sentry™) External Insulin Pumps . ANY of the following external insulin pumps * is considered medically necessary for the management of type 1 and type 2 diabetes mellitus: • an external insulin pump* (HCPCS code E0784) including a combined or integrated continuous

  Hypoglycemic

Welcome to Cigna Behavioral Health

The practitioner has thirty (30) days from the receipt of the suspension or termination letter to make a written request for reconsideration. Cigna Behavioral Health's Credentialing Committee Appeal Panel will review the appeal at its next monthly meeting and issue a written notification of the outcome to the practitioner.

  Practitioner

Speech Therapy - Cigna

speech-language pathologist for a significant voice disorder associated with the laryngeal structures that are associated with anatomic abnormality, neurological condition, injury (e.g., vocal nodules or polyps, vocal cord paresis or paralysis, paradoxical vocal …

  Paralysis, Laryngeal

Nucleic Acid Pathogen Testing - Cigna

o human papillomavirus (HPV) cervical cancer screening • Symptomatic individuals when the associated signs and symptoms or diagnoses, are listed in the ... Chlamydial infection is the most frequently reported infectious disease in the United States (IDSA, 2018; CDC,

  Pathogens, Testing, Human, Acid, Infections, Cervical, Nucleic, Papillomavirus, Human papillomavirus, Nucleic acid pathogen testing

Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation (TMS) for Depression . Transcranial magnetic stimulation (TMS) is a non-invasive neurostimulation technique that modulates cortical excitability. In repetitive TMS (rTMS), trains of several pulses are delivered through repeated stimulation over the same area with frequencies ranging from 1 to 20 Hz.

  Stimulation

Oncology Medication Clinical Coverage - UHCprovider.com

Eligard, Lupron Depot 7.5 mg (J9217) Lupron Depot 3.75 mg (J1950) Gemcitabine . Infugem (gemcitabine in sodium chloride injection) Kanjinti (trastuzumab-anns) Trazimera (trastuzumab-qyyp) Herceptin (trastuzumab) Herceptin Hylecta (trastuzumab and hyaluronidase-oysk)

  Clinical, Medication, Coverage, Oncology, Depot, Lupron, Lupron depot, Oncology medication clinical coverage

January 2022 2022 EMPIRE PLAN FLEXIBLE FORMULARY …

LUPRON DEPOT SGM valsartan MISCELLANEOUS AVASTIN SGM ERIVEDGE SGM LYNPARZA SGM RUBRACA SGM ZEJULA SGM CARDIOVASCULAR fosinopril lisinopril erindopril quinapril ramipril trandolapril § ACE INHIBITOR / CALCIUM CHANNEL BLOCKER COMBINATIONS amlodipine-benazepril trandolapril-verapamil ext-rel

  Plan, Empires, Depot, Lupron, Lupron depot, Empire plan

Lupron Depot®, Lupron Depot-Ped®, Eligard® (leuprolide ...

May 01, 2018 · Lupron Depot is administered intramuscularly (IM), Eligard is administered subcutaneously (SQ) VI. Billing Code/Availability Information Drug Name Strength HCPCS* NDC Lupron Depot 1-Month 3.75 mg J1950 00074-3641-xx Lupron Depot 1-Month 7.5 mg J9217 00074-3642-xx Lupron Depot 3-Month 11.25 mg J1950 00074-3663-xx ...

  Depot, Lupron, Lupron depot

Prior Authorization Program Information

* Important information on page 1 . Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association Prior Authorization Program Information

  Florida, Blue, Florida blue

Medications listed below are covered under the PrudentRx ...

Medications on the PrudentRx specialty drug list may change at any time, with or without notice. Your plan may not cover certain medications even though they appear on the PrudentRx drug list.

Services that require precertification

Genetic and genomic tests requiring precertification The following list is a guide to the types of genetic and genomic tests that require precertification.