Topic

Cigna

A collection of 1084 issues

How to Get Vyondys 53 (golodirsen) Covered by Cigna in New York: Complete Prior Authorization Guide

Answer Box: To get Vyondys 53 (golodirsen) covered by Cigna in New York, you need prior authorization with genetic testing confirming an exon 53-skippable DMD mutation, a neurologist's prescription, and baseline functional assessments. Submit through Express Scripts provider portal or call 1-800-882-4462. Standard review takes 2-7 business days;

How to Get Myozyme (Alglucosidase Alfa) Covered by Cigna in Ohio: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Myozyme (Alglucosidase Alfa) Covered by Cigna in Ohio Cigna requires prior authorization for Myozyme (alglucosidase alfa) in Ohio, typically approved within 5-7 business days when complete documentation is submitted. Essential requirements include confirmed Pompe disease diagnosis (enzyme/genetic testing), metabolic specialist prescriber, and dosing ≤20 mg/kg

How to Get Berinert (C1-Esterase Inhibitor) Covered by Cigna in North Carolina: Complete PA Guide with Appeal Scripts

Quick Answer: To get Berinert covered by Cigna in North Carolina, you'll need prior authorization with documented HAE diagnosis (low C4 and C1-INH levels), ICD-10 code D84.1, and prescription by an allergist/immunologist. Submit through Cigna's provider portal or Accredo specialty pharmacy. If denied, file

How to Get Qinlock (ripretinib) Covered by Cigna in Florida: Prior Authorization, Appeals, and Timeline Guide

Answer Box: Getting Qinlock Covered by Cigna in Florida Qinlock (ripretinib) requires prior authorization from Cigna for advanced GIST patients who've failed at least three kinase inhibitors (imatinib, sunitinib, regorafenib). Your oncologist must submit documentation proving prior TKI failures, current disease status, and NCCN guideline support. If denied,

Coding That Helps Get Juxtapid (lomitapide) Approved by Cigna in Michigan: ICD-10, HCPCS, and NDC Guide

Answer Box: Getting Juxtapid (lomitapide) Coded Correctly for Cigna Coverage in Michigan Juxtapid (lomitapide) requires precise coding to avoid Cigna denials in Michigan. Use ICD-10 code E78.010 (homozygous familial hypercholesterolemia) effective 2025, HCPCS code J8499 (oral non-chemotherapeutic drug, NOS), and verify NDC numbers for specific capsule strengths through the

Myths vs. Facts: Getting Firazyr (icatibant injection) Covered by Cigna in North Carolina

Answer Box: Getting Firazyr Covered by Cigna in North Carolina Cigna covers Firazyr (icatibant) for confirmed HAE Type I/II with prior authorization requiring specialist prescription, C1-INH/C4 lab documentation, and self-administration training proof. If denied, you have 180 days for internal appeals, then can use North Carolina's

How to Get Busulfex (Busulfan Injection) Covered by Cigna in Washington: Complete Prior Authorization and Appeals Guide

Quick Answer: Busulfex (busulfan injection) typically requires prior authorization from Cigna in Washington, billed under medical benefit with HCPCS J0594. Submit PA through Cigna provider portal or EviCore with complete conditioning regimen details, diagnosis codes, and medical necessity letter. If denied, file internal appeal within 180 days, then request external

How to Get Takhzyro (lanadelumab-flyo) Covered by Cigna in Ohio: Decision Tree, Forms, and Appeals

Answer Box: Qualifying for Takhzyro (lanadelumab-flyo) Coverage in Ohio Yes, you can get Takhzyro covered by Cigna in Ohio if you have confirmed hereditary angioedema (HAE) type I or II with documented attacks. Three-step path: (1) Confirm your HAE diagnosis with required lab tests (C4, C1-INH levels), (2) Have your

How to Get Joenja (leniolisib) Approved by Cigna in Florida: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Joenja (leniolisib) covered by Cigna in Florida requires genetic confirmation of APDS with pathogenic PIK3CD/PIK3R1 variants, specialist prescriber involvement, and documentation of failed standard therapies. Submit prior authorization via Cigna's portal or Florida PA form (fax 866-873-8279). Expect 72-hour standard review, 24-hour expedited. If

Get Ilaris (Canakinumab) Covered by Cigna in Virginia: Complete Prior Authorization & Appeals Guide

Answer Box: Getting Ilaris (Canakinumab) Covered by Cigna in Virginia Cigna covers Ilaris (canakinumab) for FDA-approved conditions like Still's disease and periodic fever syndromes under Policy IP0235, requiring prior authorization with specific criteria. To get approval in Virginia: 1. Gather documentation: CRP ≥10 mg/L (within 3 months)