This version of the policy will become effective 06/03/2019.
This policy has been updated to be consistent with the US Food and Drug Administration (FDA) labeling. Dosing and frequency requirements were added for all the agents. Laboratory and/or genetic testing was added for all diagnoses. Code S9357 (Home infusion therapy, enzyme replacement intravenous therapy) was removed from the policy document, but remains eligible for administration in a home setting.
Policy: MA08.012b:Off-label Coverage for Prescription Drugs and/or Biologics