Topic

Onivyde (irinotecan liposome)

A collection of 28 issues

Renewing Onivyde (Irinotecan Liposome) Approval with Blue Cross Blue Shield in Virginia: Annual Review Requirements and Timeline

Answer Box: Renewing Your Onivyde Coverage Anthem Blue Cross Blue Shield Virginia requires annual prior authorization renewal for Onivyde (irinotecan liposome). Start the renewal process 30-45 days before your current authorization expires to avoid treatment interruptions. Your oncologist must submit updated clinical documentation through Availity Essentials showing continued medical necessity,
6 min read

How to Get Onivyde (Irinotecan Liposome) Covered by Cigna in Pennsylvania: Forms, Appeals & Approval Process

Answer Box: Fastest Path to Onivyde Coverage Onivyde (irinotecan liposome) requires prior authorization from Cigna in Pennsylvania. Your oncologist must submit clinical documentation showing metastatic pancreatic adenocarcinoma, progression on gemcitabine-based therapy, and adequate organ function (ECOG 0-1). The drug is typically covered on Cigna formularies but with strict medical necessity
5 min read

How to Get Onivyde (Irinotecan Liposome) Covered by Humana in Ohio: Complete Coding, Prior Authorization, and Appeals Guide

Quick Answer: Getting Onivyde Covered by Humana in Ohio Onivyde (irinotecan liposome) requires prior authorization from Humana for all regimens. The fastest path: ensure your oncologist submits complete documentation with correct ICD-10 codes (C25.0-C25.9 for pancreatic cancer), HCPCS code J9205, and medical necessity justification referencing FDA approval for
6 min read

How to Get Onivyde (Irinotecan Liposome) Covered by Humana in Washington: Prior Authorization, Appeals & Network Requirements

Answer Box: Getting Onivyde Covered by Humana in Washington Humana covers Onivyde (irinotecan liposome) in Washington, but requires prior authorization (PA) for all regimens. The NALIRIFOX combination (Onivyde + oxaliplatin + 5-FU + leucovorin) is FDA-approved for first-line metastatic pancreatic cancer as of February 2024. Fastest path to approval: 1. Submit PA request
6 min read