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tci Part B Insider - 2003 Issue 10
LOCAL COVERAGE POLICIES: CIGNA Policies Limit Sinus Endoscopy
In Tennessee, Cigna Healthcare unveiled two new draft local medical review policies with comments due by Aug. 12: * Alefacept therapy (J3490). This treatment for psoriasis is covered only for chronic plaque psoriasis. Patients must have failed to respond to topical and UVB therapies, have a medical contraindication to such therapies, or give rise to a reasonable expectation that such therapies wouldn't be effective. The patient may repeat this therapy if the initial course results in remission and then 12 weeks elapses before a relapse.Physicians must have CD4+ lymphocyte counts available, and they must have considered other systemic...
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