Growth Hormone Therapy
|
|
- Kristian Rice
- 7 years ago
- Views:
Transcription
1 Growth Hormone Therapy Policy Number: Original Effective Date: MM /21/1999 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 04/24/2015 Section: Prescription Drugs Place(s) of Service: Home I. Description Growth hormone therapy is a long-term, injectable therapy primarily used in children and adolescents with documented growth hormone deficiencies. Human growth hormone (GH), also known as somatotropin, is synthesized in the somatotrophic cells of the pituitary gland. Since 1985, recombinant GH has been marketed as replacement therapy for children and adults with various diagnoses. II. Criteria/Guidelines Initial therapy with human growth hormone is covered (subject to Administrative Guidelines) for one of the following indications: A. Children with evidence of growth hormone deficiency (GHD) must meet the following criteria: 1. Biochemical Criteria: a. Documentation of abnormal responses to two growth hormone (GH) stimulation tests defined as less than 10 nanograms per milliliter (ng/ml) or as otherwise determined by the testing lab; or b. At least one GH stimulation test response less than15 ng/ml, and both IGF-l and IGF-BP3 levels below normal for age and gender; or c. One GH stimulation test response below 10 ng/ml with defined CNS pathology, history of cranial irradiation or genetic conditions associated with GHD; or d. Two or more documented pituitary hormone deficiencies other than GH; or e. Abnormally low GH level documented in association with neonatal hypoglycemia; and 2. Auxologic Criteria a. Height equal to or less than two standard deviations below the mean for age and gender; or b. Height equal to or less than one standard deviation below the mean and growth velocity less than one standard deviation below the mean for age and gender; and i. A minimum of one year of growth data is required with measurements at least six months apart and performed by an endocrinologist; or
2 Growth Hormone Therapy 2 ii. Patient must have four or more height determinations measured at least six months apart, by the patient s primary care physician, over a period of at least two years. Results must show a consistent growth pattern; and c. Radiologic documentation of open growth plates in patients over 12 years of age. B. Children with idiopathic short stature, familial short stature, or small for gestational age infants with failure of catch-up growth by the age of two must meet the following criteria: 1. Auxologic Criteria: a. Height less than or equal to 2.25 standard deviations below the mean for age and gender; and b. Growth velocity equal to or less than one standard deviation below the mean for age and gender measured in accordance with II.A.2.b; and c. Radiologic documentation of open growth plates in patients over 12 years of age. C. Turner s syndrome: Patients must meet the following criteria: 1. Open growth plates in patients over 12 years of age; and 2. Height below the tenth percentile for age. D. Noonan s syndrome: Patients must meet the following criteria: 1. Open growth plates in patients over 12 years of age; and 2. Height below the tenth percentile for age and gender. E. Prader-Willi syndrome: Patients must meet the following criteria: 1. Open growth plates in patients over 12 years of age; and 2. Height below the tenth percentile for age and gender. F. Children with chronic renal insufficiency: Patients must meet the following criteria: 1. Creatinine clearance less than or equal to 75 ml/min per 1.73 m 2 or serum creatinine greater than 3.0 mg/dl, or dialysis dependent; and 2. Radiographic documentation of open growth plates in patients over 12 years of age; and G. Acquired Immune Deficiency Syndrome (AIDS) wasting: Patients must meet the following criteria: 1. Greater than 10 percent of baseline weight loss that cannot be explained by a concurrent illness other than HIV infection; and 2. Simultaneous treatment with antiviral agents. H. Burn patients: Patients must meet the following criteria: 1. Extensive 3rd-degree burns; or 2. Burns greater than or equal to 40 percent total body surface area. I. Short bowel syndrome: Patients must meet the following criteria: 1. Receiving specialized nutritional support; and 2. Optimal management of short bowel syndrome.
3 Growth Hormone Therapy 3 J. Adults with evidence of GH deficiency 1. Irreversible hypothalamic/pituitary structural lesions or ablation: no further testing needed. 2. Defect in GH synthesis: no further testing needed. 3. GH deficiency in childhood, circumstances other than J.1 or J.2. Only about 25% of children with GH deficiency will be found to have GH deficiency as adults. Therefore, once adult height has been achieved, patients should be retested for GH deficiency after at least a one month break in GH therapy to determine if continuing replacement is necessary in accordance with one of the following criteria: a. Three or more pituitary hormone deficiencies and IGF-1 level below laboratory s range of normal: no further testing necessary; b. Peak GH level in response to insulin tolerance test less than or equal to 5.0 ng/ml and IGF-1 level below laboratory's range of normal; c. Peak GH level in response to glucagon stimulation test less than or equal to 3.0 ng/ml and IGF-1 level below laboratory's range of normal; d. Peak GH level in response to arginine stimulation test less than or equal to 0.4 ng/ml and IGF-1 level below laboratory's range of normal. Note: Levadopa and clonidine stimulation tests are not acceptable for documenting persistence of GH deficiency into adulthood. Continuation of therapy is covered (subject to Limitations and Administrative Guidelines) when the continuation of therapy criteria listed in the chart below (in Administrative Guidelines) are met. III. Administrative Guidelines A. Precertification is required. To precertify, please complete HMSA's Precertification Request and mail or fax the form as indicated. B. Children approved for GHT under previous HMSA policies will be approved for continuation of therapy in accordance with current continuation criteria. C. Children receiving GHT without previous HMSA authorization will be considered for continuation of therapy in accordance with current initiation criteria (per clinical data prior to initiation of therapy) and current continuation criteria (per current clinical data). D. Children previously treated with GHT but who have had treatment subsequently discontinued will be considered for re-initiation of therapy in accordance with current initial treatment criteria (per current clinical data) and continuation criteria except growth velocity (per current clinical data).
4 Growth Hormone Therapy 4 Table 1 Indication Pediatric short stature Turner s syndrome Noonan s syndrome Prader-Willi syndrome Chronic Renal Insufficiency Adult GHD Burn patients Short bowel syndrome AIDS wasting Table 2 Indication Growth hormone deficiency Pediatric short stature Turner s syndrome Noonan s syndrome Prader-Willi syndrome Chronic Renal Insufficiency Adult GHD Short bowel syndrome Burn patients AIDS wasting Initial Authorization Period Up to 12 months Up to 12 months Four weeks Up to 12 months Continuation of Therapy Approved in 12 month increments with current documentation of: Growth velocity greater than or equal to two centimeters per year; and Open growth plates in children over 12 years of age; and Height less than fifth percentile of normal adult height for gender (150 centimeters for girls, 165 centimeters for boys). Can be approved in 12 month increments No further authorization shall be given Codes J2941 and NDC number Description Injection somatropin, 1 mg (e.g. Nutropin/Nutropin AQ) IV. Important Reminder The purpose of this Medical Policy is to provide a guide to coverage. This Medical Policy is not intended to dictate to providers how to practice medicine. Nothing in this Medical Policy is intended to discourage or prohibit providing other medical advice or treatment deemed appropriate by the treating physician.
5 Growth Hormone Therapy 5 Benefit determinations are subject to applicable member contract language. To the extent there are any conflicts between these guidelines and the contract language, the contract language will control. This Medical Policy has been developed through consideration of the medical necessity criteria under Hawaii s Patients Bill of Rights and Responsibilities Act (Hawaii Revised Statutes 432E-1.4), generally accepted standards of medical practice and review of medical literature and government approval status. HMSA has determined that services not covered under this Medical Policy will not be medically necessary under Hawaii law in most cases. If a treating physician disagrees with HMSA s determination as to medical necessity in a given case, the physician may request that HMSA reconsider the application of the medical necessity criteria to the case at issue in light of any supporting documentation. V. References 1. AACE Guidelines for clinical practice for growth hormone use in adults and children, 2003 update. Endocrine Practice Vol 9 No. 1 Jan/Feb American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists medical guidelines for clinical practice for growth hormone use in growth hormone-deficient adults and transition patients 2009 update. 3. Centers for Disease Control and Prevention. Growth Charts. Accessed 11/25/ Cohen P, Rogol AD, Deal CL, et al. Consensus statement on the diagnosis and treatment of children with idiopathic short stature: a summary of the Growth Hormone Research Society, the Lawson Wilkins Pediatric Endocrine Society, and the European Society for Paediatric Endocrinology Workshop. J Clin Endocrinol Metab. Nov 2008; 93(11): Consensus Guidelines for the Diagnosis and Treatment of Adults with Growth Hormone Deficiency: Summary Statement of the Growth Hormone Research Society Workshop on Adult Growth Hormone 6. Cook DM, Yuen KC, Biller BM, Kemp SF, Vance ML, American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists medical guidelines for clinical practice for growth hormone use in growth hormone-deficient adults and transition patients update. Endocrinology Practice 2009 Sep-Oct; 15 Suppl 2: Deal CL, Tony M, Hoybye C, et al. Growth hormone research society workshop summary: consensus guidelines for recombinant human growth hormone therapy in Prader-Willi syndrome. J Clin Endocrinol Metab. Jun 2013;98(6):E Deficiency, Journal of Clinical Endocrinology & Metabolism, :2, Cook DM, Yuen KC, Biller BM, Kemp SF, Vance ML, American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists medical guidelines for clinical practice for growth hormone use in growth hormone-deficient adults and transition patients update. Endocrinology Practice Sep-Oct; 15 Suppl 2: Endocrine Society. Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab Jun; 96(6): Human Growth Hormone. Blue Cross Blue Shield Association Medical Policy Reference Manual. Policy , October 2014.
6 Growth Hormone Therapy Genentech product information, Nutropin/Nutropin AQ, June GH Research Society. Consensus guidelines for the diagnosis and treatment of growth hormone deficiency in childhood and adolescence: summary statement of the GH Research Society. Journal of Clinical Endocrinology & Metabolism 2000; 85(11): National Institute for Health and Clinical Excellence (NICE). Human growth hormone (somatropin) for growth failure in children: NICE guidance 188. May Rosenfeld RG et al. Diagnostic controversy: The diagnosis of childhood growth hormone deficiency revisited. Journal of Clinical Endocrinology & Metabolism 1995; 80: Tanner JM et al. Clinical longitudinal standards for height and height velocity for North American children. Journal of Pediatrics 1985; 107(3): Wilson TA, Rose SR, Cohen P, et.al., Update of guidelines for the use of growth hormone in children: the Lawson Wilkins Pediatric Endocrinology Society Drug and Therapeutics Committee. Journal of Pediatrics. 2003; Oct. 143(4): Wood AJ. Treatments for wasting in patients with the acquired immunodeficiency syndrome. New England. Journal of Medicine 1999; 340(22): VI. Appendix The values corresponding to specific z-scores are contained in this Excel data file. This file contains the z-scores values for gender (1=male; 2=female). For example, 1.5 months represents months. The only exception is birth, which represents the point at birth. Centers for Disease Control and Prevention Growth Chart Z- Score Data Files
Growth Hormone Therapy
Growth Hormone Therapy Policy Number: Original Effective Date: MM.04.011 05/21/1999 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST 10/28/2011 Section: Prescription Drugs Place(s) of Service:
More informationGROWTH HORMONE THERAPY
GROWTH HORMONE THERAPY Line(s) of Business: HMO; PPO; QUEST Integration Original Effective Date: 05/21/1999 Current Effective Date: 10/01/2015 POLICY A. INDICATIONS The indications below including FDA-approved
More informationFDA Approved Indications
Preferred Agents: Humatrope (somatropin) Nutropin (somatropin) Medication Nutropin AQ (somatropin) Nutropin AQ NuSpin (somatropin) Non-Preferred Agents: Genotropin (somatropin) Omnitrope (somatropin) Norditropin
More informationPrior Authorization Form
Prior Authorization Form Growth Hormone This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information, sign and date. Fax signed forms to CVS/Caremark at
More informationGrowth Hormone Deficiency
Growth Hormone Deficiency What is growth hormone deficiency? 1,2 Growth hormone deficiency is when your body doesn t make enough growth hormone. Growth hormone is one of many hormones made by the pituitary
More informationObtaining insurance coverage for human growth hormone treatment for Idiopathic Short Stature In 2003, the Food and Drug Administration (FDA) approved
Obtaining insurance coverage for human growth hormone treatment for Idiopathic Short Stature In 2003, the Food and Drug Administration (FDA) approved the use of growth hormone (GH) for the long-term treatment
More informationPolicy/Criteria: Human Growth Hormone may be considered medically necessary if the following conditions are met:
This policy has been developed through review of medical literature, consideration of medical necessity, generally accepted medical practice standards, and approved by the IEHP Pharmacy and Therapeutics
More informationEndocrine issues in FA SUSAN R. ROSE CINCINNATI CHILDREN S HOSPITAL MEDICAL CENTER
Endocrine issues in FA SUSAN R. ROSE CINCINNATI CHILDREN S HOSPITAL MEDICAL CENTER 80% of children and adults with FA have an endocrine abnormality Endocrine cells make a hormone (message) Carried in bloodstream
More informationApplied Behavior Analysis Therapy for Treatment of Autism Spectrum Disorder
Applied Behavior Analysis Therapy for Treatment of Autism Spectrum Disorder Policy Number: Original Effective Date: MM.12.022 01/01/2016 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration
More informationPatient Satisfaction and Therapeutic Adherence Considerations of rhgh Dosing Devices
Patient Satisfaction and Therapeutic Adherence Considerations of rhgh Dosing Devices Robert Lipsy, PharmD Clinical Assistant Professor Department of Pharmacy Practice and Sciences University of Arizona
More informationExternal Insulin Pumps Corporate Medical Policy
External Insulin Pumps Corporate Medical Policy File name: External Insulin Pumps File code: UM.DME.02 Origination: 4/2006 Last Review: 02/2014 (ICD-10 remediation only) Next Review: 10/2014 Effective
More informationRecombinant human growth hormone therapy may be considered medically necessary for the following patients:
ϯ ϯ ϯ A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association PRIOR AUTHORIZATION: GROWTH HORMONE Coverage Recombinant
More informationGrowth Hormone Deficiency A Guide for Parents and Patients
Growth Hormone Deficiency A Guide for Parents and Patients SERIES 1 SERIES 2 SERIES 3 SERIES 4 SERIES 5 SERIES 6 SERIES 7 SERIES 8 SERIES 9 SERIES 10 SERIES 11 SERIES 12 SERIES 13 SERIES 14 SERIES 15 SERIES
More informationUSEFULNESS OF BONE AGE IN PAEDIATRIC ENDOCRINOLOGY. Rina Balducci Center of Pediatric Endocrinology, Department of Public Health and Cell Biology
USEFULNESS OF BONE AGE IN PAEDIATRIC ENDOCRINOLOGY Gian Luigi Spadoni and Stefano Cianfarani Rina Balducci Center of Pediatric Endocrinology, Department of Public Health and Cell Biology Tor Vergata University,
More informationHawaii Benchmarks Benefits under the Affordable Care Act (ACA)
Hawaii Benchmarks Benefits under the Affordable Care Act (ACA) 10/2012 Coverage for Newborn and Foster Children Coverage Outside the Provider Network Adult Routine Physical Exams Well-Baby and Well-Child
More informationShort Synacthen Test for the Investigation of Adrenal Insufficiency
Pathology at the Royal Derby Hospital Short Synacthen Test Standard Clinical Guidelines Chemical Pathology Department Valid Until 31 st March 2015 Document Code: CHISCG1 Short Synacthen Test for the Investigation
More informationtestosterone_pellet_implantation_for_androgen_deficiency_in_men 10/2015 N/A 11/2016 10/2015 This policy is not effective until December 30, 2015
Corporate Medical Policy Testosterone Pellet Implantation for Androgen Deficiency in File Name: Origination: Last CAP Review: Next CAP Review: Last Review: testosterone_pellet_implantation_for_androgen_deficiency_in_men
More informationHypothyroidism. Written by Donald Yung Edited by Dianna Louie. Basic Embryology and Anatomy
Hypothyroidism Written by Donald Yung Basic Embryology and Anatomy The thyroid gland consists of two lobes connected by an isthmus and is located anterior to the trachea at the base of the neck. During
More informationModifier Usage Guide What Your Practice Needs to Know
BlueCross BlueShield of Mississippi Modifier Usage Guide What Your Practice Needs to Know Modifier 22 Usage Modifier 22 - Procedural Service The purpose of this modifier is to report services (surgical
More informationThe sensitive marker for glomerular filtration rate (GFR) Estimation of GFR from Serum Cystatin C:
The sensitive marker for glomerular filtration rate (GFR) Estimation of GFR from Serum Cystatin C: The good correlation allows close estimation of GFR Cystatin C GFR GFR in serum estimated* measured* n
More informationInsulin Infusion Pumps
Medical Coverage Policy Insulin Infusion Pumps EFFECTIVE DATE: 09/01/2004 POLICY LAST UPDATED: 08/06/2013 OVERVIEW The policy addresses insulin infusion pumps that are worn externally and those that are
More informationPOLICY A. INDICATIONS
Alimta (pemetrexed) Line(s) of Business: HMO; PPO; QUEST Integration Akamai Advantage Original Effective Date: 09/01/2007 Current Effective Date: 10/01/2015 POLICY A. INDICATIONS The indications below
More informationHealthcare services requiring prior authorisation
Annex 2 Healthcare requiring prior authorisation This list does not include organ transplants and does also not apply to long-term care and the primary purpose of which is to support people in need of
More informationFailure to Thrive: Rethinking Our Treatment Goals Darren Fiore, MD 2013 Advances & Controversies in Clinical Pediatrics. Tips and Reference Sheet
Failure to Thrive: Rethinking Our Treatment Goals Darren Fiore, MD 2013 Advances & Controversies in Clinical Pediatrics Tips and Reference Sheet Various Definitions of FTT: Weight < 5th percentile for
More informationNursing - Graduate (NGRD)
Loma Linda University 2015-2016 1 Nursing - Graduate (NGRD) Courses NGRD 500. Primary Care Adult-Gerontology Nurse Practioner: Fragile elders. 2 Continues development of the A-GNP role of health promotion,
More informationEndocrine Causes of Chronic Fatigue Syndrome (CFS)/Chronic Fatigue Immune. Deficiency Syndrome (CFIDS):
1 Endocrine Causes of Chronic Fatigue Syndrome (CFS)/Chronic Fatigue Immune Deficiency Syndrome (CFIDS): A Brief Guide for Patients and Primary Care Physicians Theodore C. Friedman and Camille Kimball
More informationApplication for Medicare Supplement
Application for Medicare Supplement This application is subject to the approval of Blue Cross and Blue Shield of Nebraska. P.O. Box 2417 Omaha, NE 68103-2417 1 Tell us about yourself. Name (First, Middle,
More informationApplication for Medicare Supplement Insurance Plan
Application for Medicare Supplement Insurance Plan Instructions Complete this application in ink and sign on the appropriate line in PART THREE. To be considered for coverage, you must be age 65 or over,
More informationFigure showing the relationship of the pituitary and hypothalamus and the sex hormone axis
GONADOTROPHIN RELEASING HORMONES ANALOGUES USAGE IN THE MANAGEMENT OF PRECOCIOUS PUBERTY. Professor Peter Hindmarsh University College London Hospitals Background Puberty arises as a result of an increase
More informationBeyond the Basics of Endocrine Stimulation Testing Las Vegas, NV. Conflict of Interest Disclosure 4/17/2013
Beyond the Basics of Endocrine Stimulation Testing Las Vegas, NV Earline Edwards MSN, APRN NP, CPNP, CDE University of NE Medical Center Children s Hospital Omaha, NE Conflict of Interest Disclosure Advisory
More informationPhysical Therapy MM.09.005 07/15/2003
Physical Therapy Policy Number: Original Effective Date: MM.09.005 07/15/2003 Line(s) of Business: Current Effective Date: HMO; PPO; EUTF; HSTA; QUEST; Federal Plan 87 09/28/2012 Line(s) of Business Excluded:
More informationHypothyroidism clinical features and treatment. 1. The causes of hypothyroidism
Hypothyroidism clinical features and treatment 1. The causes of hypothyroidism The thyroid is a gland in the neck which makes two thyroid hormones, thyroxine (T4) and tri-iodothyronine (T3). Thyroxine
More informationAt the completion of training, the resident will have acquired the following competencies and will function effectively as a:
Objectives of Training in the Subspecialty of Endocrinology and Metabolism This document applies to those who begin training on or after July 1 st, 2013. DEFINITION 2013 VERSION 2.0 Endocrinology and Metabolism
More informationOccupational Therapy
Occupational Therapy Policy Number: Original Effective Date: MM.09.003 07/15/2003 Line(s) of Business: Current Effective Date: HMO; PPO; EUTF; HSTA; QUEST; Federal Plan 87 02/01/2012 Line(s) of Business
More informationTYPE 2 DIABETES IN CHILDREN DIAGNOSIS AND THERAPY. Ines Guttmann- Bauman MD Clinical Associate Professor, Division of Pediatric Endocrinology, OHSU
TYPE 2 DIABETES IN CHILDREN DIAGNOSIS AND THERAPY Ines Guttmann- Bauman MD Clinical Associate Professor, Division of Pediatric Endocrinology, OHSU Objectives: 1. To discuss epidemiology and presentation
More informationCriteria: CWQI HCS-123 (This criteria is consistent with CMS guidelines for External Infusion Insulin Pumps)
Moda Health Plan, Inc. Medical Necessity Criteria Subject: Origination Date: 05/15 Revision Date(s): 05/2015 Developed By: Medical Criteria Committee 06/24/2015 External Infusion Insulin Pumps Page 1 of
More informationOverview of Diabetes Management. By Cindy Daversa, M.S.,R.D.,C.D.E. UCI Health
Overview of Diabetes Management By Cindy Daversa, M.S.,R.D.,C.D.E. UCI Health Objectives: Describe the pathophysiology of diabetes. From a multiorgan systems viewpoint. Identify the types of diabetes.
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Afrezza Page 1 of 6 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Afrezza (human insulin) Prime Therapeutics will review Prior Authorization requests Prior Authorization
More informationP.O. Box 91120, MS 295 Seattle, WA 98111-9220 1-800-290-1278 Fax: 425-918-5278
Oregon Medicare Supplement Enrollment Application for Plans A, F, High Deductible F and N P.O. Box 91120, MS 295 Seattle, WA 98111-9220 1-800-290-1278 Fax: 425-918-5278 You are eligible to apply for a
More informationA Parent s Guide to Understanding Congenital Hypothyroidism. Children s of Alabama Department of Pediatric Endocrinology
A Parent s Guide to Understanding Congenital Hypothyroidism Children s of Alabama Department of Pediatric Endocrinology How did you get here? Every baby born in the state of Alabama is required by law
More informationUniversity of Michigan Group: 007005187-0000, 0001 Comprehensive Major Medical (CMM) Benefits-at-a-Glance
University of Michigan Group: 007005187-0000, 0001 Comprehensive Major Medical (CMM) Benefits-at-a-Glance This is intended as an easy-to-read summary and provides only a general overview of your benefits.
More informationETIOLOGIC CLASSIFICATION. Type I diabetes Type II diabetes
DIABETES MELLITUS DEFINITION It is a common, chronic, metabolic syndrome characterized by hyperglycemia as a cardinal biochemical feature. Resulting from absolute lack of insulin. Abnormal metabolism of
More informationBenefit Summary - A, G, C, E, Y, J and M
Benefit Summary - A, G, C, E, Y, J and M Benefit Year: Calendar Year Payment for Services Deductible Individual $600 $1,200 Family (Embedded*) $1,200 $2,400 Coinsurance (the percentage amount the Covered
More informationOrdering and interpreting thyroid tests in children. Paul Kaplowitz, MD, PhD Children s National Medical Center, Washington, DC
Ordering and interpreting thyroid tests in children Paul Kaplowitz, MD, PhD Children s National Medical Center, Washington, DC Objectives To review indications for thyroid testing To discuss which tests
More informationContinuity Clinic Educational Didactic. December 8 th December 12 th
Continuity Clinic Educational Didactic December 8 th December 12 th MKSAP Question 1 A 60-year-old man is evaluated for a 1-year history of generalized fatigue and lack of energy. He has had erectile dysfunction
More informationDiabetes Mellitus. Melissa Meredith M.D. Diabetes Mellitus
Melissa Meredith M.D. Diabetes mellitus is a group of metabolic diseases characterized by high blood glucose resulting from defects in insulin secretion, insulin action, or both Diabetes is a chronic,
More informationSUMMARY TABLE OF MEASURE CHANGES
Summary Table of Measure 1 SUMMARY TABLE OF MEASURE CHANGES Guidelines for Physician Measurement Effectiveness of Preventive Care Guidelines for Physician Effectiveness of Care Adult BMI Assessment Weight
More informationApplication for Senior Medicare Supplement Plans BLUE CROSS AND BLUE SHIELD OF MONTANA P.O. BOX 4309 HELENA, MT 59604
Application for Senior Medicare Supplement Plans BLUE CROSS AND BLUE SHIELD OF MONTANA P.O. BOX 4309 HELENA, MT 59604 SENIORAPP062010 FLD New Enrollment Change Benefit Plan (e.g., Plan F to Plan C) Transfer
More informationKyphoplasty and Vertebroplasty
Kyphoplasty and Vertebroplasty Policy Number: Original Effective Date: MM.06.007 01/11/2005 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST 10/26/2012 Section: Surgery Place(s) of Service:
More informationEndocrine Responses to Resistance Exercise
chapter 3 Endocrine Responses to Resistance Exercise Chapter Objectives Understand basic concepts of endocrinology. Explain the physiological roles of anabolic hormones. Describe hormonal responses to
More informationHAWAII BOARD OF MEDICAL EXAMINERS PAIN MANAGEMENT GUIDELINES
Pursuant to section 453-1.5, Hawaii Revised Statutes, the Board of Medical Examiners ("Board") has established guidelines for physicians with respect to the care and treatment of patients with severe acute
More informationHEALTH DEPARTMENT BILLING GUIDELINES
HEALTH DEPARTMENT BILLING GUIDELINES Acknowledgement: Current Procedural Terminology (CPT ) is copyright 2015 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative
More informationTraditional View of Diabetes. Are children with type 1 diabetes obese: What can we do? 8/9/2012. Change in Traditional View of Diabetes
Are children with type 1 diabetes obese: What can we do? Traditional View of Diabetes Type 1 Diabetes ( T1DM) Onset Juvenile Lean Type 2 Diabetes ( T2DM) Onset Adult Obese QI Project Indrajit Majumdar
More informationUNDERSTANDING MULTIPLE MYELOMA AND LABORATORY VALUES Benjamin Parsons, DO bmparson@gundersenhealth.org Gundersen Health System Center for Cancer and
UNDERSTANDING MULTIPLE MYELOMA AND LABORATORY VALUES Benjamin Parsons, DO bmparson@gundersenhealth.org Gundersen Health System Center for Cancer and Blood Disorders La Crosse, WI UNDERSTANDING MULTIPLE
More informationDepartment Of Biochemistry. Subject: Diabetes Mellitus. Supervisor: Dr.Hazim Allawi & Dr.Omar Akram Prepared by : Shahad Ismael. 2 nd stage.
Department Of Biochemistry Subject: Diabetes Mellitus Supervisor: Dr.Hazim Allawi & Dr.Omar Akram Prepared by : Shahad Ismael. 2 nd stage. Diabetes mellitus : Type 1 & Type 2 What is diabestes mellitus?
More informationKIDNEY/PANCREAS REFERRAL PACKET Please attach the following information with each application.
KIDNEY/PANCREAS REFERRAL PACKET Please attach the following information with each application. 1. Patient s history and physical (less than one year old). 2. Recent labs, current medication list and radiology
More information嘉 義 長 庚 醫 院 藥 劑 科 Speaker : 翁 玟 雯
The Clinical Efficacy and Safety of Sodium Glucose Cotransporter-2 (SGLT2) Inhibitors in Adults with Type 2 Diabetes Mellitus 嘉 義 長 庚 醫 院 藥 劑 科 Speaker : 翁 玟 雯 Diabetes Mellitus : A group of diseases characterized
More informationMedical Clinical Assistant
Medical Clinical Assistant Pennsylvania CIP 51.0801 This document describes the correlation between curriculum, supplied by Applied Educational Systems, and the Medical Clinical Assistant standard, published
More informationTestosterone; What s all the hype? KRISTEN WYRICK, LTCOL,USAFR, MC USUHS, FAMILY MEDICINE JOINT BASE LANGLEY-EUSTIS
Testosterone; What s all the hype? KRISTEN WYRICK, LTCOL,USAFR, MC USUHS, FAMILY MEDICINE JOINT BASE LANGLEY-EUSTIS The faces of Low Testosterone What your patients are seeing Pharmacy Industry Testosterone
More informationELECTROMYOGRAPHY (EMG), NEEDLE, NERVE CONDUCTION STUDIES (NCS) AND QUANTITATIVE SENSORY TESTING (QST)
AND QUANTITATIVE SENSORY TESTING (QST) Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Medical
More informationInsulin like Growth Factor 1 as an Indicator of Growth Hormone Deficiency
Insulin like Growth Factor 1 as an Indicator of Growth Hormone Deficiency Hussein Alawneh MD *, Omar Khaledi MD *, Jamal Maita MD *, Neveen Fugaha RN **, Raeda Otoom RN **, Mohammad Shatnawi MD * ABSTRACT
More informationHI-IQ details available online
HMSA s For Participating Medical Practitioners MAY 2007 INDEX draft medical policies 2 bluecard cdhp 2 locum tenens 3 immunization mac changes 3 referring physician name 4 annual review of policies 4 alglucosidase
More informationBenefit Coverage Chart & Rates Effective July 1, 2014 June 30, 2015
Benefit Coverage Chart & Rates Effective PPO Medical Coverage by Category The following coverages are included with the PPO plan: o Prescription o Vision Additional Benefits o Dental o Dental & Orthodontia
More informationREFERENCE ACTION ANALYST STAFF DIRECTOR or BUDGET/POLICY CHIEF
HOUSE OF REPRESENTATIVES STAFF ANALYSIS BILL #: CS/HB 1041 Controlled Substances SPONSOR(S): Criminal Justice Subcommittee; Berman TIED BILLS: IDEN./SIM. BILLS: CS/SB 1448 REFERENCE ACTION ANALYST STAFF
More informationDiabetes mellitus. Lecture Outline
Diabetes mellitus Lecture Outline I. Diagnosis II. Epidemiology III. Causes of diabetes IV. Health Problems and Diabetes V. Treating Diabetes VI. Physical activity and diabetes 1 Diabetes Disorder characterized
More informationREGISTERED NURSE PRACTITIONER (RNP) PRACTICING IN AN ACUTE CARE SETTING October 2009 Adopted by the Board 11/19/09 Background
Janice Brewer Governor Joey Ridenour Executive Director Arizona State Board of Nursing 4747 N. 7 th Street Phoenix, AZ 85014-3653 Phone (602) 771-7888 Fax (602) 771-7800 E-Mail: prandolph@azbn.gov Home
More informationNATIONAL OSTEOPOROSIS FOUNDATION OSTEOPOROSIS CLINICAL UPDATES Vitamin D and Bone Health CE APPLICATION FORM
NATIONAL OSTEOPOROSIS FOUNDATION OSTEOPOROSIS CLINICAL UPDATES Vitamin D and Bone Health CE APPLICATION FORM First Name: Last Name: Mailing Address: City: State: Zip/Postal Code: Country: Phone Number:
More informationAPPLICATION FOR THE RN to BSN PROGRAM NAME: ADDRESS:
APPLICATION FOR THE RN to BSN PROGRAM PLEASE PRINT CLEARLY NAME: ADDRESS: Please check Campus you wish to attend: Rutgers Camden: Atlantic Cape Community College: Camden County College at Blackwood: Home
More informationSchedule of Benefits Summary. Health Plan. Out-of-network Provider
Schedule of Benefits Summary University Name: University of Nebraska - Student Plan Health Plan : 2014/2015 Academic Year (see attached) Payment for Services Covered Services are reimbursed based on the
More informationP.O. Box 91120, MS 295 Seattle, WA 98111-9220 1-800-752-6663 Fax: 425-918-5278
Washington Medicare Supplement Enrollment Application for Plans A, F, High Deductible F and N P.O. Box 91120, MS 295 Seattle, WA 98111-9220 1-800-752-6663 Fax: 425-918-5278 ou are eligible to apply for
More informationMeaningful Use Objectives
Meaningful Use Objectives The purpose of the electronic health records (EHR) incentive program is not so much the adoption of health information technology (HIT), but rather how HIT can further the goals
More informationMedical Terminology APS-100-TE. TECEP Test Description
Medical Terminology APS-100-TE This TECEP tests the material usually taught in a course on the everyday medical terminology used by healthcare and medical professionals. It focuses on the word parts, word
More informationPreventing Pediatric Diabetes: Are Racial Disparities A Factor? A Children s Health Fund Issue Brief February 2004
Preventing Pediatric Diabetes: Are Racial Disparities A Factor? A Children s Health Fund Issue Brief February 2004 The Children s Health Fund The Children s Health Fund (CHF), working with hospitals and
More information2015 Orange County HICAP Medicare Advantage Special Needs Plans Comparison Chart
Brand New Day Brand New Day Brand New Day Brand New Day Bridges Drug Savings Bridges Extra Care Harmony Healthy Heart Drug Savings dementia. dementia. chronic and disabling mental health conditions. chronic
More informationCYSTIC FIBROSIS CLINICS AS A MODEL OF INTERPROFESSIONAL CARE
CYSTIC FIBROSIS CLINICS AS A MODEL OF INTERPROFESSIONAL CARE 1. Cystic fibrosis introduction 2. CF Foundation centers 3. Care disciplines: physician specialists (pulmonary, GI, endocrine, genetics, palliative
More informationHypogonadism and Testosterone Replacement in Men with HIV
NORTHWEST AIDS EDUCATION AND TRAINING CENTER Hypogonadism and Testosterone Replacement in Men with HIV Stephanie T. Page, MD, PhD Robert B. McMillen Professor in Lipid Research, Associate Professor of
More informationLast name First name Middle initial Social Security number (required)
Alaska Medicare Supplement Enrollment Application for Plans A, F, High Deductible F and N 2550 Denali St., Suite 1404 Anchorage, AK 99503 1-888-669-2583 Fax: 907-258-1619 ou are eligible to apply for a
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Human Growth Hormone Page 1 of 33 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Human Growth Hormone Pre-Determination of Services IS REQUIRED by the Member s
More informationTuberculosis And Diabetes. Dr. hanan abuelrus Prof.of internal medicine Assiut University
Tuberculosis And Diabetes Dr. hanan abuelrus Prof.of internal medicine Assiut University TUBERCULOSIS FACTS More than 9 million people fall sick with tuberculosis (TB) every year. Over 1.5 million die
More informationMEDICAL COVERAGE POLICY. SERVICE: Insulin Pump and Continuous Glucose Monitoring. PRIOR AUTHORIZATION: Required. POLICY:
Important note Even though this policy may indicate that a particular service or supply may be considered covered, this conclusion is not based upon the terms of your particular benefit plan. Each benefit
More informationThe Influence of Infant Health on Adult Chronic Disease
The Influence of Infant Health on Adult Chronic Disease Womb to Tomb Dr Clare MacVicar Introduction Many diseases in adulthood are related to growth patterns during early life Maternal nutrition important
More informationTABLE OF CONTENTS. Home Infusion Therapy Guidelines... 2
TABLE OF CONTENTS Home Infusion Therapy Guidelines... 2 Services normally considered eligible for benefits... 2 Description... 2 Pre-certification Requirements... 3 Billing Guidelines... 3 Home Infusion
More informationBULLETIN. Slovak Republic Ministry of Health
BULLETIN Slovak Republic Ministry of Health Part 51-53 November 13, 2009 No. 57 CONTENTS: 52. Slovak Republic Ministry of Health Guidelines for the Diagnosis of Glucocorticoidinduced Osteoporosis 52. Slovak
More informationPractice Guidelines. Professional Practice Medical Record Documentation Guidelines
Practice Guidelines 2010 Professional Practice Medical Record Documentation Guidelines Health care benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage
More informationVetsulin. CurveKit. Unparalleled support for managing canine and feline diabetes only from Merck Animal Health
Vetsulin CurveKit Glucose curve workpad How-to instructions Interpretation guidelines Unparalleled support for managing canine and feline diabetes only from Merck Animal Health How to chart your patients
More informationAdministering DTaP during the Shortage
PROVIDER SERVICES Policies/ Procedures/ Claims HMO 215/567-3590 800/227-3119* PPO 800/332-2566 PHARMACY SERVICES Prescription Drug Authorization 888/671-5280 Toll-Free Fax 888/671-5285 Blood Glucose Meter
More informationBlueSecure HMO Plan Benefit Summary
BlueSecure HMO Plan Benefit Summary NETWORK LIMITATIONS NETWORK PROVIDERS ALLOWED AMOUNT Except for emergencies, all covered services must be rendered by a network provider. Outside Arizona, this plan
More informationNURSE PRACTITIONER STANDARDS FOR PRACTICE
NURSE PRACTITIONER STANDARDS FOR PRACTICE February 2012 Acknowledgement The Association of Registered Nurses of Prince Edward Island gratefully acknowledges permission granted by the Nurses Association
More informationMember s responsibility (deductibles, copays, coinsurance and dollar maximums)
MICHIGAN CATHOLIC CONFERENCE January 2015 Benefit Summary This is intended as an easy-to-read summary and provides only a general overview of your benefits. It is not a contract. Additional limitations
More informationDiagnosis, classification and prevention of diabetes
Diagnosis, classification and prevention of diabetes Section 1 1 of 4 Curriculum Module II 1 Diagnosis, classification and presentation of diabetes Slide 2 of 48 Polyurea Definition of diabetes Slide 3
More informationTreatment of diabetes In order to survive, people with type 1 diabetes must have insulin delivered by a pump or injections.
National Diabetes Statistics What is diabetes? Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.
More informationN Basic, including 100% Part B coinsurance. Basic including 100% Part B coinsurance* Basic including 100% Part B coinsurance
HEARTLAND NATIONAL LIFE INSURANCE COMPANY Outline of Medicare Supplement Coverage Benefit Plans A, D, F, G, M and N Benefit Chart of Medicare Supplement Plans Sold for Effective Dates on or After Jun 1,
More informationGraves disease in childhood Antithyroid drug therapy
83rd Annual Meeting of the ATA October 620, 203 Duration of antithyroid drugs treatment Disclosure Nothing to disclose Pr Juliane Léger Paediatric Endocrinology Department Paris Diderot University Hôpital
More informationCommittee Approval Date: October 14, 2014 Next Review Date: March 2015
Medication Policy Manual Topic: Testosterone replacement therapy products: - Androderm, - Axiron, - Fortesta, - Striant, - Testim Gel, - Natesto, - Vogelxo Policy No: dru297 Date of Origin: March 15, 2013
More informationDiabetes Medications: Insulin Therapy
Diabetes Medications: Insulin Therapy Courtesy Univ Texas San Antonio Eric L. Johnson, M.D. Department of Family and Community Medicine Diabetes and Insulin Type 1 Diabetes Autoimmune destruction of beta
More informationSHIIP Combo Form. 1-855-408-1212 www.ncshiip.com. North Carolina Department of Insurance Wayne Goodwin, Commissioner
SHIIP Combo Form Seniors Health Insurance Information Program North Carolina Department of Insurance Wayne Goodwin, Commissioner 1-855-408-1212 www.ncshiip.com What is SHIIP? Seniors Health Insurance Information
More informationConroe Physician Associates. Patient Consent Form. I fully understand that this is given in advance of any specific diagnosis or treatment.
Conroe Physician Associates Patient Consent Form Please Read and Sign I, undersigned, hereby consent to the following: Administration and performance of all treatments Administration of any needed anesthetics
More informationUnderstanding Growth: Normal vs. Abnormal Patterns Facilitator s Guide
Understanding Growth: Normal vs. Abnormal Patterns Facilitator s Guide Case Author: Laurie E. Cohen, MD Harvard Medical School Children s Hospital, Boston Case Advisors: S. Jean Emans, MD John R. Knight,
More informationThe State Health Benefits Program Plan
State of New Jersey Department of the Treasury Division of Pensions and Benefits STATE HEALTH BENEFITS PROGRAM PLAN COMPARISON SUMMARY FOR STATE EMPLOYEES EFFECTIVE APRIL 1, 2008 (March 29, 2008 for State
More information