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It is medically necessary that the drug be administered by an implanted infusion pump; and The drug is medically necessary for the treatment of members see medical necessity criteria for various types of infusion pumps below ; and The infusion pump has been approved by the FDA for infusion of the particular drug that is to be administered.
Anti-Spasmodic Drugs Aetna considers an implantable infusion pump medically necessary when used to intrathecally administer anti-spasmodic drugs e. Member has failed a six-week trial of non-invasive methods of spasticity control, such as oral anti-spasmodic drugs, either because these methods fail to adequately control the spasticity or produce intolerable side effects; and Member has a favorable response to a trial intrathecal dosage of the anti-spasmodic drug prior to pump implantation.
Intrathecal baclofen Lioresal is considered medically necessary for the treatment of intractable spasticity caused by spinal cord disease, spinal cord injury, or multiple sclerosis and for stiff person syndrome.
Baclofen is considered medically necessary for persons who require spasticity to sustain upright posture, balance in locomotion, or increased function. Documentation in the member's medical record should indicate that the member's spasticity was unresponsive to other treatment methods and that the oral form of baclofen was ineffective in controlling spasticity or that the member could not tolerate the oral form of the drug.
A trial of oral baclofen is not a required prerequisite to intrathecal baclofen therapy in children ages 12 years old or less due to the increased risk of adverse effects from oral baclofen in this group.
The medical record should document that the member showed a favorable response to the trial dosage of the baclofen before subsequent dosages are considered medically necessary.
An implanted pump for continuous fusion is considered not medically necessary for members who do not respond to a mcg intrathecal bolus. Intrathecal baclofen, when combined with other agents clonidine, hydromorphone, morphine, and zinconotideis considered experimental and investigational because the safety and effectiveness of these combinations has not been established.
The member's history must indicate that he or she has not responded adequately to non-invasive methods of pain control, such as systemic opioids including attempts to eliminate physical and behavioral abnormalities which may cause an exaggerated reaction to pain. An implantable infusion pump is considered medically necessary when used to administer opioid drugs e.
Intrahepatic Chemotherapy Infusion for Liver Metastases from Colorectal Cancer Implantable infusion pumps are considered medically necessary for administration of intrahepatic chemotherapy e.
Aetna considers "one-shot" arterial chemotherapy for persons with liver metastases from colorectal cancer experimental and investigational. Hospital discharge is dependent on resolution of pain, nausea and vomiting which complicate the procedure. Contraindications to Implantable Infusion Pumps Implantable infusion pumps are considered not medically necessary for persons with the following contraindications to implantable infusion pumps: Members who have an active infection that may increase the risk of the implantable infusion pump; or Members whose body size is insufficient to support the weight and bulk of the device; or Members with known allergy or hypersensitivity to the drug being used e.
Implantable infusion pumps for intrahepatic administration of chemotherapy for indications other than noted above, including treatment of hepatic metastases from cancers other than colorectal cancer; or Implantable pumps for the infusion of heparin for recurrent thromboembolic disease; or Implantable pumps for the infusion of insulin to treat diabetes; or Implantable pumps for the infusion of baclofen for chronic neuropathic pain e.
External Infusion Pumps Aetna considers external infusion pumps medically necessary DME for administration of any of the following medications: Certain parenteral anticancer chemotherapy drugs e. Aetna considers external infusion pumps experimental and investigational for all other indications.
Members must meet all of the following criteria: The member has been on a program of multiple daily injections of insulin i. Aetna considers external infusion pumps for diabetes experimental and investigational where the above-listed criteria are not met.
It may be considered medically necessary for poorly controlled women with diabetes to sometimes get started on the pump pre-pregnancy or in the first trimester. Notes on External Insulin Infusion Pumps: Aetna considers a programmable disposable external insulin infusion pump e. Aetna's medical necessity criteria for external infusion pumps for diabetes have been adapted from Medicare national policy on external insulin infusion pumps, as outlined in CMS's Coverage Issues Manual Section Documentation of continued medical necessity of the external insulin infusion pump requires that the member be seen and evaluated by the treating physician at least once every 6 months.
External subcutaneous insulin infusion pumps are only considered medically necessary for persons who have demonstrated ability and commitment to comply with a regimen of pump care, frequent self-monitoring of blood glucose, and careful attention to diet and exercise.
Some external insulin infusion pumps e. These insulin pump features, when present, are considered integral to the external insulin infusion pump and blood glucose monitor.
The pump must be ordered by and follow-up care of the member must be managed by a physician with experience managing persons with insulin infusion pumps and who works closely with a team including nurses, diabetic educators, and dieticians who are knowledgeable in the use of insulin infusion pumps.
Such supplies include those drugs and biologicals that must be put directly into the equipment in order to achieve the therapeutic benefit of the DME or to assure the proper functioning of the equipment.
Replacement Pumps Replacement of a functioning insulin pump with an insulin pump with wireless communication to a glucose monitor is considered not medically necessary as such wireless communication has not been shown to improve clinical outcomes Replacement of an external insulin pump is considered medically necessary for children who require a larger insulin reservoir.
The replacement of infusion pumps that are out of warranty, are malfunctioning, and cannot be refurbished is considered medically necessary. Baclofen Lioresal is a derivative of gamma aminobutyric acid GABA that acts specifically at the spinal end of the upper motor neurons to cause muscle relaxation.
Intrathecal baclofen may be indicated for patients with severe chronic spasticity of spinal cord origin. An implantable infusion pump is required for the administration of intrathecal baclofen. Intrathecal baclofen therapy is indicated for persons with severe chronic spasticity of spinal cord origin including multiple sclerosis that is refractory to oral baclofen or where there are unacceptable side effects from oral baclofen at the effective dose.
The patient should be shown to respond to a single intrathecal bolus dose of up to mcgs of baclofen. A positive response is defined as an average two-point drop on an objective muscle tone or spasm screening system e.
According to available guidelines, intrathecal baclofen therapy is not considered appropriate if the patient has a history of hypersensitivity to Lioresal, is pregnant or has inadequate birth control, has severely impaired renal function, has severe hepatic or gastrointestinal disease, or has cerebral lesions as the source of spasticity.
The result is facilitation of daily caring, and symptomatic relief from painful spasm.Mayo Clinic Health Letter provides reliable, authoritative and accurate health information.
Discover why it is one of the leading health publications. Number: (Includes CPB ) Policy. Note: Except for Medicare plans and where coverage is mandated by state law, generally coverage for diabetic supplies would be provided under a pharmacy rider and not as part of medical benjaminpohle.comn diabetic supplies may also be covered under the medical plan if no pharmacy or diabetic supplies rider is available.
Diabetes insipidus, usually a disorder of the pituitary gland, leading to a form of type II diabetes.
A group of metabolic diseases whereby a person (or other animal) has high blood sugar due to an inability to produce, or inability to metabolize, sufficient quantities of the hormone insulin. diabetes mellitus translation in English-Tagalog dictionary. Glosbe. English ; diabetes mellitus in Tagalog translation and definition "diabetes mellitus", naging malinaw na hindi lamang trangkaso ang sakit ni Ken—mayroon din siyang Type 1 diabetes mellitus — diyabetis, sa maikli.
The Patient Satisfaction Rating is an average of all responses to the care provider related questions shown below from our nationally-recognized Press Ganey Patient Satisfaction benjaminpohle.comts that are treated in outpatient or hospital environments may receive different surveys, and the volume of responses will vary by question.
(Tagalog) May Mayo 4 na Hakbang upang Pigilin ang. Iyong Diyabetis. Habang Buhay. (jes-TAY-shon-al) diabetes mellitus (GDM)—occurs when a woman is pregnant.
It raises her risk of getting another type of diabetes, mostly type 2, sa iyong health care team upang maabot ang iyong mga ABC na layunin. Gamitin itong plano sa.