Topic

Firdapse (amifampridine)

A collection of 22 issues

How to Get Firdapse (Amifampridine) Covered by Cigna in Georgia: Complete Appeals Guide with Forms and Deadlines

Answer Box: Getting Firdapse Covered by Cigna in Georgia Cigna requires prior authorization for Firdapse (amifampridine) in Georgia with specific documentation requirements. Your neurologist must submit a PA request confirming LEMS diagnosis via electrodiagnostic studies or antibody testing, patient age ≥6 years, no seizure history, and specialist involvement. If denied,

How to Get Firdapse (Amifampridine) Covered by Aetna CVS Health in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Firdapse Covered by Aetna CVS Health in Texas Aetna CVS Health requires prior authorization for Firdapse (amifampridine) in Texas. To get approved, you need: (1) confirmed LEMS diagnosis with EMG showing ≥60% increment or positive VGCC antibodies, (2) prescription from a neurologist/neuromuscular specialist, and (3) documentation

How to Get Firdapse (Amifampridine) Covered by Humana in Michigan: Complete Guide to Prior Authorization and Appeals

Quick Answer: Firdapse (amifampridine) requires prior authorization from Humana Medicare Advantage/Part D in Michigan. You'll need confirmed LEMS diagnosis by a neuromuscular specialist, EMG results showing >60% CMAP increment, VGCC antibody testing, and cancer screening. Submit through Humana's provider portal with complete clinical documentation.

Coding That Helps Get Firdapse (amifampridine) Covered by Humana in Pennsylvania: ICD-10, NDC, and Billing Requirements

Answer Box: Getting Firdapse (amifampridine) Covered by Humana in Pennsylvania Quick approval path: Use ICD-10 codes G70.80 or G70.81 for Lambert-Eaton myasthenic syndrome (LEMS), bill with the correct Firdapse NDC (49948-100-01 for 10mg tablets), and submit via Medicare Part D pharmacy benefit—not Part B. Humana requires prior

How to Get Firdapse (Amifampridine) Covered by UnitedHealthcare in Michigan: Complete Prior Authorization Guide with Appeals Process

Answer Box: Getting Firdapse Covered by UnitedHealthcare in Michigan UnitedHealthcare requires prior authorization for Firdapse (amifampridine) in Michigan, with no step therapy required for confirmed LEMS patients. The fastest path to approval: (1) Ensure your neurologist has documented LEMS diagnosis with P/Q-type VGCC antibodies and EMG findings, (2) Submit

How to Get Firdapse (Amifampridine) Covered by Aetna CVS Health in Florida: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Firdapse Covered by Aetna CVS Health in Florida Fastest path to approval: Submit prior authorization through Aetna's provider portal with neurologist documentation, EMG showing ≥60% increment, VGCC antibody results (if positive), and ICD-10 code G70.80. If denied, file internal appeal within 180 days, then

How to Get Firdapse (Amifampridine) Covered by UnitedHealthcare in North Carolina: Complete Guide with Appeals Process and State Protections

Answer Box: Getting Firdapse Covered in North Carolina UnitedHealthcare requires prior authorization for Firdapse (amifampridine) in North Carolina. Your fastest path to approval: (1) Have your neurologist submit a complete PA request with confirmed LEMS diagnosis (EMG showing >60% increment, P/Q-type VGCC antibodies), clinical documentation of functional impairment,

Do You Qualify for Firdapse Coverage by UnitedHealthcare in Virginia? Decision Tree & Next Steps

Answer Box: Your Path to Firdapse Coverage in Virginia You likely qualify for Firdapse (amifampridine) coverage by UnitedHealthcare if: you're 6+ years old with confirmed LEMS diagnosis (EMG + antibody testing), prescribed by a neurologist, and not using other potassium channel blockers. UnitedHealthcare requires prior authorization but no step

How to Get Firdapse (Amifampridine) Covered by Aetna CVS Health in Pennsylvania: Appeals Guide with Forms and Timelines

Answer Box: Getting Firdapse (Amifampridine) Covered by Aetna CVS Health in Pennsylvania Fastest path to approval: 1) Have your neurologist submit prior authorization through Aetna's provider portal with confirmed LEMS diagnosis (antibody tests, EMG), documentation of seizure risk assessment, and dosing justification. 2) If denied, file internal appeal

How to Get Firdapse (Amifampridine) Covered by UnitedHealthcare in Pennsylvania: Complete Guide with Appeals Process

Answer Box: Getting Firdapse Covered by UnitedHealthcare in Pennsylvania UnitedHealthcare requires prior authorization for Firdapse (amifampridine) for Lambert-Eaton myasthenic syndrome (LEMS). No step therapy is required, but you need confirmed LEMS diagnosis with antibody testing and EMG documentation from a neuromuscular specialist. Submit PA through the UnitedHealthcare Provider Portal. If