Topic

Photrexa (riboflavin ophthalmic solution)

A collection of 24 issues

How to Get Photrexa (Riboflavin) Covered by Cigna in Virginia: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Photrexa Covered by Cigna in Virginia Cigna requires prior authorization for Photrexa (riboflavin ophthalmic solution) used in corneal cross-linking for keratoconus in Virginia. Your ophthalmologist must document progressive disease with serial corneal topography showing ≥1.0 diopter increase in maximum keratometry (Kmax) and failed conservative treatments. Submit

How to Get Photrexa (Riboflavin) Covered by Aetna CVS Health in Michigan: Complete Prior Authorization and Appeals Guide

Answer Box: Fast Track to Photrexa Coverage Aetna CVS Health requires prior authorization for Photrexa (riboflavin ophthalmic solution) corneal cross-linking in Michigan. Key requirements: progressive keratoconus documented by serial Kmax readings (≥1 diopter increase over 12 months), corneal thickness ≥400 microns, and use of FDA-approved iLink system. Submit via Aetna&

How to Get Photrexa Covered by Humana in California: Prior Authorization Guide & Appeals Process

Answer Box: Getting Photrexa Covered by Humana in California Photrexa (riboflavin ophthalmic solution) is covered by Humana Medicare Advantage plans in California, but prior authorization is required. The fastest path to approval: (1) Your eye doctor submits a PA request with progression documentation (Kmax increase ≥1.0 D or pachymetry

How to Get Photrexa (Riboflavin) Covered by Aetna CVS Health in Georgia: Complete PA Guide & Appeal Forms

Answer Box: Getting Photrexa Covered by Aetna CVS Health in Georgia Fastest path to approval: Submit prior authorization through Aetna's Availity portal with documented progressive keratoconus (serial topography showing Kmax progression), corneal thickness ≥400 microns, and ophthalmologist consultation. If denied, you have 180 days to appeal internally, then

Getting Photrexa (Riboflavin) Covered by Cigna in Florida: Complete Guide to Prior Authorization, Appeals, and Cost Savings

Answer Box: Getting Photrexa Covered by Cigna in Florida Cigna requires prior authorization for Photrexa (riboflavin ophthalmic solution) used in corneal cross-linking for progressive keratoconus. To get coverage in Florida: 1. Document progression: Gather serial corneal topography showing Kmax increase ≥1.0 diopter 2. Submit PA: Use CoverMyMeds or Cigna

How to Get Photrexa (Riboflavin) Covered by Aetna CVS Health in Pennsylvania: Prior Authorization Guide

Quick Answer: Getting Photrexa Covered by Aetna CVS Health in Pennsylvania Aetna CVS Health requires prior authorization for Photrexa (riboflavin ophthalmic solution) used in FDA-approved corneal cross-linking for progressive keratoconus in Pennsylvania. Your fastest path to approval: (1) Gather documented progression evidence (serial topography showing Kmax increases, pachymetry showing thinning)

How to Get Photrexa (Riboflavin) Covered by Humana in Illinois: Coding, Appeals & Prior Authorization Guide

Answer Box: Getting Photrexa Covered by Humana in Illinois Photrexa (riboflavin ophthalmic solution) requires prior authorization from Humana for corneal collagen cross-linking in progressive keratoconus or corneal ectasia. The fastest path to approval: 1) Use correct codes (ICD-10 H18.62x for unstable keratoconus, HCPCS J2787 x2 units, CPT 0402T), 2)

Get Photrexa (Riboflavin) Covered by Humana in Virginia: Prior Authorization Guide

Quick Answer: Getting Photrexa Covered by Humana in Virginia Humana requires prior authorization for Photrexa (riboflavin) corneal crosslinking procedures. Your ophthalmologist must submit documentation proving progressive keratoconus with objective measurements (Kmax increase ≥1.0 diopter, pachymetry decrease ≥15 microns over 12 months). If denied, Virginia's Bureau of Insurance

How to Get Photrexa (Riboflavin) Covered by Aetna CVS Health in Ohio: Complete Prior Authorization Guide

Answer Box: Getting Photrexa Covered by Aetna CVS Health in Ohio Aetna CVS Health covers epithelium-off corneal cross-linking with Photrexa for progressive keratoconus and ectasia. The fastest path to approval: 1) Verify your plan covers CPT code 0402T, 2) Submit prior authorization with documented keratoconus progression (serial topography, Kmax increases)

Get Photrexa (Riboflavin) Covered by Cigna in Washington: Complete Appeals Guide with Forms and Deadlines

Answer Box: Getting Photrexa Covered by Cigna in Washington Cigna requires prior authorization for Photrexa (riboflavin ophthalmic solution) as part of corneal cross-linking for progressive keratoconus. To get approval: 1. Submit PA electronically via CoverMyMeds or Cigna Provider Portal with documented progression evidence (Kmax increase ≥1.0 D, serial topography)