Lupron Injections Medical Policies

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Gonadotropin Releasing Hormone …

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/gonadotropin-releasing-hormone-analogs.pdf

Gonadotropin-Releasing Hormone Analogs and …

https://www.aetna.com/cpb/medical/data/500_599/0501.html

Lupron Depot Injection: Uses, Dosage & Side Effects

https://www.drugs.com/lupron.html

Lupron Depot is used in women to treat symptoms of endometriosis (overgrowth of uterine lining outside of the uterus) or uterine fibroids. Lupron Depot …

Clinical Policy: Leuprolide Acetate (Eligard, …

https://www.healthnet.com/content/dam/centene/healthnet/pdfs/provider/ca/policies/876.pdf

It is the policy of health plans affiliated with Centene Corporation® that leuprolide acetate, Eligard, Lupaneta Pack, Lupron Depot, and Lupron Depot-Ped are medically necessary …

CLINICAL MEDICATION POLICY - Highmark Health Options

https://www.highmarkhealthoptions.com/content/dam/digital-marketing/en/highmark/highmarkhealthoptions/providers/medical-payment-policies/Lupron.pdf

LUPRON DEPOT is contraindicated in individuals with known hypersensitivity to GnRH agonists or any ...

Lupron injection: Uses, Side Effects, Interactions, …

https://www.webmd.com/drugs/2/drug-10836/lupron-injection/details

Before using this medication, tell your doctor or pharmacist your medical history, especially of: diabetes, heart disease (such as heart attack ), stroke, high cholesterol, mental/mood …

Billing guidelines for leuprolide acetate (Lupron Depot® …

https://provcomm.ibx.com/ibc/Archive/Pages/F1CFB2A301C6D11A852580A00071E2F1.aspx

Although Lupron Depot has been approved by the U.S. Food and Drug Administration (FDA) for prostate cancer and Compendia supports the use of Lupron Depot for breast …

Article - Billing and Coding: Luteinizing Hormone …

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=52453

The medical record documentation for patients receiving a once-yearly implant should support ongoing follow-up visits at least every three (3) to four (4) …

Clinical Criteria - Anthem

https://www.anthem.com/ca/ms/pharmacyinformation/clinicalcriteria.html

Clinical Criteria Welcome to the Clinical Criteria Page This page provides the clinical criteria documents for all injectable, infused, or implanted prescription drugs and therapies …

Medical Policies | Wellmark Blue Cross & Blue Shield

https://www.wellmark.com/member/medical-policies

Medical Policies. Medical policies are guidelines used to determine coverage for specific medical technologies, procedures, equipment and services. These policies state …

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