Topic

Lumizyme (alglucosidase alfa)

A collection of 23 issues

The Requirements Checklist to Get Lumizyme (alglucosidase alfa) Covered by Blue Cross Blue Shield in Georgia: Prior Authorization, Appeals, and Documentation Guide

Answer Box: Getting Lumizyme Covered by Blue Cross Blue Shield in Georgia Blue Cross Blue Shield of Georgia (Anthem) requires prior authorization for Lumizyme (alglucosidase alfa) with confirmed Pompe disease diagnosis via enzyme/genetic testing. Submit PA requests through the Availity provider portal with baseline function tests and specialist prescriber

Coding That Helps Get Lumizyme (alglucosidase alfa) Approved in Texas with Blue Cross Blue Shield: ICD-10, HCPCS/J-Code, NDC Guide

Answer Box: Essential Coding for Lumizyme Approval Getting Lumizyme (alglucosidase alfa) approved by Blue Cross Blue Shield of Texas requires precise coding: ICD-10 E74.02 (Pompe disease), HCPCS J0221 (10 mg units), and proper NDC 58468-0160-xx. Prior authorization is required for most BCBS Texas plans. Submit via Availity Authorization &

How to Get Lumizyme (alglucosidase alfa) Covered by Aetna (CVS Health) in Georgia: Complete Authorization Guide

Quick Answer: Getting Lumizyme Covered by Aetna in Georgia Aetna requires prior authorization for Lumizyme (alglucosidase alfa) with confirmed Pompe disease diagnosis and specialist prescriber. Submit the Aetna Lumizyme Precertification Form with enzyme assay or genetic testing results. If denied, you have 60 days to request external review through the

Getting Lumizyme (Alglucosidase Alfa) Approved by Cigna in Texas: A Real Patient's Journey From Denial to Coverage

Answer Box: Getting Lumizyme Covered by Cigna in Texas Fastest path to approval: Submit prior authorization with enzyme deficiency confirmation, genetic testing results, and specialist prescription through Cigna's provider portal. Key requirements: GAA enzyme activity testing, genetic confirmation, and prescription by metabolic specialist or neurologist experienced with lysosomal

Getting Lumizyme (Alglucosidase Alfa) Covered by Humana in Virginia: Cost-Saving Strategies and Appeals Guide

Answer Box: Fast Track to Coverage Lumizyme requires prior authorization from Humana with diagnostic confirmation of Pompe disease and specialist prescribing. Three steps to start today: (1) Contact your physician to initiate PA through Humana at 1-866-488-5995, (2) Apply for Sanofi's copay assistance if you have commercial insurance

How to Get Lumizyme (Alglucosidase Alfa) Covered by Humana in Illinois: Coding, Prior Authorization, and Appeals Guide

Quick Answer: Getting Lumizyme Covered by Humana in Illinois Lumizyme (alglucosidase alfa) requires prior authorization from Humana and must be prescribed by a specialist familiar with Pompe disease. Use ICD-10 code E74.02 for billing, and ensure your doctor submits comprehensive documentation including enzyme testing results and genetic confirmation. If

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

Answer Box: Getting Lumizyme Covered by Cigna in Illinois Cigna requires prior authorization for Lumizyme (alglucosidase alfa) in Illinois. To get approval, you need: (1) confirmed Pompe disease diagnosis with enzyme/genetic testing, (2) specialist prescriber documentation, and (3) medical necessity letter showing clinical rationale. If denied, Illinois provides automatic

How to Get Lumizyme (Alglucosidase Alfa) Covered by Humana in Florida: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Lumizyme Covered by Humana in Florida Lumizyme (alglucosidase alfa) requires prior authorization from Humana Medicare Advantage plans in Florida. The fastest path to approval: (1) Confirm your Pompe disease diagnosis with both enzyme testing and genetic confirmation, (2) Have your doctor submit a prior authorization request with

Myths vs. Facts: Getting Lumizyme (Alglucosidase Alfa) Covered by Cigna in Michigan - Appeals Guide 2025

Answer Box: Getting Lumizyme Covered by Cigna in Michigan Cigna requires prior authorization for Lumizyme (alglucosidase alfa) with confirmed Pompe disease diagnosis, specialist involvement, and comprehensive documentation. If denied, you have 180 days to appeal internally, then 127 days for Michigan DIFS external review. First step today: Gather enzyme testing

How to Get Lumizyme (Alglucosidase Alfa) Covered by Blue Cross Blue Shield in Pennsylvania: Forms, Appeals, and Success Strategies

Quick Answer: Getting Lumizyme Covered by Blue Cross Blue Shield in Pennsylvania Lumizyme (alglucosidase alfa) requires prior authorization from all Blue Cross Blue Shield plans in Pennsylvania. Your fastest path to approval: 1) Have your specialist submit the PA request through the electronic portal (Availity for Highmark, online forms for