{"id":6423,"date":"2021-03-30T16:00:49","date_gmt":"2021-03-30T16:00:49","guid":{"rendered":"http:\/\/hnetalk.com\/provider\/?p=6423"},"modified":"2021-03-30T17:10:35","modified_gmt":"2021-03-30T17:10:35","slug":"photochemotherapy-puva-phototherapy-laser-treatments","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/provider\/photochemotherapy-puva-phototherapy-laser-treatments\/","title":{"rendered":"Clinical Review Criteria Update &#8211; Photochemotherapy (PUVA), Phototherapy, Laser Treatments"},"content":{"rendered":"<p>Policy Number: UM460POL<br \/>\nEffective Date: 6\/1\/2021<br \/>\nLOB Affected: Commercial, Medicare, Medicaid<br \/>\nPolicy Type: Medical<\/p>\n<ul>\n<li>I., Criteria for Approval of Photochemotherapy (PUVA) with Psoralens (96912, 96913)<\/li>\n<\/ul>\n<p>C.:\u00a0 Added 7. (Nursing mothers) and 8. (History of lupus erythematosus)<\/p>\n<ul>\n<li>III., A.: 4., b.:<\/li>\n<\/ul>\n<p><em>From:\u00a0<\/em><em>\u00a0<\/em>b., Vitiligo when both criteria below are met:<\/p>\n<p>i., Involves &lt;5 % of BSA; AND<\/p>\n<p>ii., Treatment for Vitiligo is limited to no more than 12 consecutive calendar weeks with review required for up to 12 additional treatments.<\/p>\n<p><em>To:\u00a0<\/em>b., Vitiligo when\u00a0 2 of the below criteria are met:<\/p>\n<p>i., Involves &lt;5 % of BSA; AND<\/p>\n<p>ii., Treatment for Vitiligo is limited to no more than 12 consecutive calendar weeks with review required for up to 12 additional treatments.<\/p>\n<p>iii., Area that is being treated cannot be adequately reached during light box treatments OR<\/p>\n<ul>\n<li>IV., What is Not Covered\/Considered Experimental, Investigational, or Unproved<\/li>\n<\/ul>\n<p>A.:\u00a0 Added # 7:\u00a0 \u201cTreatments for acne scarring or active acne\u201d<\/p>\n<ul>\n<li>Source\/Citation Section: Updated all resources<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Policy Number: UM460POL Effective Date: 6\/1\/2021 LOB Affected: Commercial, Medicare, Medicaid Policy Type: Medical I., Criteria for Approval of Photochemotherapy (PUVA) with Psoralens (96912, 96913) C.:\u00a0 Added 7. (Nursing mothers) and 8. (History of lupus erythematosus) III., A.: 4., b.: From:\u00a0\u00a0b., Vitiligo when both criteria below are met: i., Involves &lt;5 % of BSA; AND [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":4349,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[92],"tags":[],"class_list":["post-6423","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-provider-newsletter"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/hnetalk.com\/provider\/wp-content\/uploads\/2018\/10\/laptop.doc-e1539797356812.png?fit=800%2C547","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-1FB","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/6423","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=6423"}],"version-history":[{"count":4,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/6423\/revisions"}],"predecessor-version":[{"id":6431,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/6423\/revisions\/6431"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media\/4349"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=6423"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=6423"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=6423"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}