WebThis page outlines the Site of Care for Specialty Drug Administration policy and the medications to which this policy applies. It provides the criteria used to determine the medical necessity of hospital outpatient administration as the site of service for identified specialty medications (See Site of Care for Specialty Drug Infusion/Injection applicable … WebOur Clinical Policy Bulletins (CPBs) explain the medical, dental and pharmacy services we may or may not cover. They are based on objective, credible sources, such as the scientific literature, guidelines, consensus statements and expert opinions. Medical Clinical Policy Bulletins Dental Clinical Policy Bulletins Pharmacy Clinical Policy Bulletins
Drug Infusion/Injection Services Policy for Providers Aetna
WebDALVANCE is administered via intravenous infusion, using a total infusion time of 30 minutes to minimize the risk of infusion-related reactions. Rapid intravenous infusions of DALVANCE can cause reactions that resemble “Red-Man Syndrome,” including flushing of the upper body, urticaria, pruritus, and/or rash. WebFeb 21, 2024 · The Medical Policy Department, in collaboration with physician specialists, develop and maintain medical necessity and coverage guidelines for all medical-surgical products for the Commercial and Medicare Advantage lines of business. These guidelines address medical services, including diagnostic and therapeutic procedures, injectable … bivouac new world
Provider Resource Center
Webreconstituted DALVANCE with intravenous medications, additives, or substances other than 5% Dextrose Injection, USP has not been established. If a common intravenous line is being used to administer other drugs in addition to DALVANCE, the line should be flushed before and after each DALVANCE infusion with 5% Dextrose Injection, USP. WebMar 28, 2024 · DALVANCE - NDC drug/product. NDCs and labelers of "DALVANCE": NDC Trade Name Labeler Name; 57970-0100: DALVANCE: Allergan, Inc. demo request yours today. ... Coding Clinic ® for HCPCS - current + archives AHA Coding Clinic ® for ICD-10-CM and ICD-10-PCS - current + archives AMA CPT ... WebNumber of HCPCS/CPT units NDC (11-digit billing format) NDC description NDC unit of measure Consider the following example for Ciprofloxacin IV 1200 MG (1 day supply): Amount of drug to be billed: 1200 MG HCPCS/CPT code: J0744 HCPCS/CPT code description: Ciprofloxacin for intravenous infusion, 200 MG bivouac military term