Topic

Lutathera (lutetium Lu-177 dotatate)

A collection of 30 issues

Work With Your Doctor to Get Lutathera Approved by Blue Cross Blue Shield in Georgia: Complete Prior Authorization Guide

Quick Answer: Blue Cross Blue Shield of Georgia (Anthem BCBS GA) requires prior authorization for Lutathera for somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors. You'll need SSTR-positive imaging, documented progression on octreotide/lanreotide, and an oncologist's letter of medical necessity. If denied, Georgia allows external review within 60
7 min read

How to Get Lutathera Covered by Humana in California: Prior Authorization Forms, Appeal Process & Success Strategies

Answer Box: Getting Lutathera Covered by Humana in California Lutathera (lutetium Lu-177 dotatate) requires prior authorization from Humana and is covered under Medicare Part B as a medical benefit. Key requirements include SSTR-positive PET imaging and documented failure/progression on somatostatin analogs like octreotide or lanreotide. If denied, California residents
7 min read

How to Get Lutathera (Lutetium Lu-177 Dotatate) Covered by Blue Cross Blue Shield in North Carolina: Complete Guide with Forms and Appeals

Answer Box: Getting Lutathera Covered by Blue Cross Blue Shield in North Carolina Blue Cross Blue Shield of North Carolina covers Lutathera (lutetium Lu-177 dotatate) for somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors when medical necessity criteria are met. Fastest path to approval: Submit prior authorization with complete documentation including SSTR-positive imaging,
5 min read

How to Get Lutathera Approved by Cigna in Florida: Complete Prior Authorization & Appeals Guide

Answer Box: Getting Lutathera Covered by Cigna in Florida Cigna typically requires prior authorization for Lutathera (lutetium Lu-177 dotatate) with documented somatostatin receptor-positive imaging and prior somatostatin analog therapy failure. Fastest approval path: Your oncologist submits the PA request with DOTATATE PET/CT results, pathology confirming GEP-NET, and progression notes
6 min read

How to Get Lutathera (lutetium Lu-177 dotatate) Covered by Cigna in Virginia: PA Requirements, Appeals, and Success Strategies

Answer Box: Your Fastest Path to Coverage To get Lutathera (lutetium Lu-177 dotatate) covered by Cigna in Virginia: Submit prior authorization with somatostatin receptor-positive imaging, documented progression on somatostatin analogs, and nuclear medicine facility credentials. If denied, file internal appeal within 180 days, then Virginia external review using Form 216-A
6 min read

Renewing Lutathera (Lutetium Lu-177 Dotatate) Approval with Humana in Illinois: Complete Timeline and Documentation Guide

Answer Box: Renewing Lutathera Coverage with Humana in Illinois Quick Answer: Lutathera requires prior authorization renewal before each treatment cycle (every 8 weeks). Submit renewal requests 30 days before your next scheduled infusion with updated SSTR imaging, treatment response documentation, and continued medical necessity evidence. If denied, you have 65
6 min read

Getting Lutathera (Lutetium Lu-177 Dotatate) Covered by Humana in North Carolina: Complete Appeal Guide with Forms and Timelines

Answer Box: Your Fastest Path to Coverage Getting Lutathera covered by Humana in North Carolina requires: SSTR-positive imaging (Ga-68 DOTATATE PET/CT preferred), pathology confirming well-differentiated NET, and documented progression despite somatostatin analog therapy. Start today by: requesting your complete medical records and SSTR imaging reports from your oncologist. Timeline:
6 min read

Getting Lutathera Covered by UnitedHealthcare in Georgia: Prior Authorization Forms, Appeal Process, and Timeline Guide

Answer Box: Your Path to Lutathera Coverage To get Lutathera covered by UnitedHealthcare in Georgia: Submit prior authorization through your oncologist with SSTR-positive imaging (Ga-68 DOTATATE PET scan), documented GEP-NET diagnosis, and evidence of somatostatin analog use. If denied, file internal appeal within 180 days, then Georgia external review within
4 min read