Topic

Kuvan (sapropterin dihydrochloride)

A collection of 34 issues

Do You Qualify for Kuvan (Sapropterin) Coverage by Aetna CVS Health in California? Decision Tree & Next Steps

Answer Box: Your Path to Kuvan Coverage Kuvan (sapropterin) is covered by Aetna CVS Health as a specialty medication with prior authorization required. Most PKU patients qualify if they have confirmed diagnosis, demonstrate BH4-responsiveness (≥20% phenylalanine reduction), and maintain dietary management under specialist care. Fastest approval path: 1. Your metabolic

How to Get Kuvan (Sapropterin) Covered by Aetna in Pennsylvania: Prior Authorization, Appeals & Alternatives

Answer Box: Getting Kuvan Covered by Aetna in Pennsylvania Kuvan (sapropterin) requires prior authorization from Aetna with documented BH4 responsiveness testing showing ≥30% blood phenylalanine reduction. If denied, Pennsylvania's new external review program overturns ~50% of appeals. First step: Have your doctor submit PA documentation including PKU diagnosis,

Getting Kuvan (Sapropterin) Covered by Humana in North Carolina: Complete Coding & Appeals Guide

Quick Answer: Your Path to Kuvan Coverage Kuvan (sapropterin) requires prior authorization from Humana, billed under Medicare Part D using NDC codes (not J-codes). Key steps: 1) Ensure correct ICD-10 coding (E70.0 for classical PKU, E70.1 for other hyperphenylalaninemia), 2) Submit weight-based dosing documentation with specialist confirmation, 3)

The Complete Guide to Getting Kuvan (Sapropterin) Covered by Blue Cross Blue Shield in Ohio: Requirements, Forms, and Appeals

Answer Box: Getting Kuvan Covered in Ohio Blue Cross Blue Shield Ohio (Anthem) requires prior authorization for Kuvan (sapropterin dihydrochloride) with specific clinical documentation. To get approval: (1) Ensure your metabolic specialist submits a complete PA form with recent blood phenylalanine levels >360 µmol/L and proof of dietary