New Rewards Coming Soon!¡Se vienen nuevas recompensas!
Our Healthy Rewards Program is getting an update in September! For a sneak peek of all the changes - including new rewards and ways to redeem them - please click here.
¡Nuestro Programa Healthy Rewards tendrá su actualización en septiembre! Para ver un adelanto de todos los cambios, incluyendo nuevas recompensas y formas de canjearlas, haz clic aquí.
Clinical Prior Authorization Updates for Epidiolex
Date: March 26, 2021Attention: NeurologistsEffective Date: May 11, 2021 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event. TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.Call to action: Effective May 11, 2021, the Texas Health and Human Services Commission (HHSC) will update the ICD-10 diagnosis codes for Epidiolex (cannabidiol) for consistency with diagnosis codes used for Diacomit (stiripentol). These drugs are FDA-approved to treat Dravet Syndrome. The following ICD-10 codes will be added to the Epidiolex prior authorization criteria:
ICD-10 Code
Description (Effective May 11, 2021)
G40411
Other generalized epilepsy and epileptic syndromes, intractable with status epilepticus
G40419
Other generalized epilepsy and epileptic syndromes, intractable without status epilepticus
G40803
Other epilepsy, intractable, with status epilepticus
G40804
Other epilepsy, intractable, without status epilepticus
Next steps for providers: Providers should share this communication with their staff. The updated Epidiolex prior authorization form will be made available near the effective date on the Navitus website (see Resources link below).
Resources:
