Erythropoiesis-Stimulating Agents (for Indiana Only)
Indiana-specific UnitedHealthcare medical benefit drug policy for erythropoiesis-stimulating agents (Aranesp, Epogen, Procrit, Retacrit, Mircera), referencing InterQual clinical criteria for medical necessity and providing applicable HCPCS/J-codes for billing reference.
Routine review; no content changes.
Coverage Summary
This Indiana-specific UnitedHealthcare medical benefit drug policy is covered_with_criteria. It applies to erythropoiesis-stimulating agents (ESAs) included in the policy: Aranesp (darbepoetin alfa), Epogen / Procrit (epoetin alfa), Retacrit (epoetin alfa-epbx), and Mircera (methoxy polyethylene glycol-epoetin beta). Coverage is available when the patient's indication meets the current InterQual clinical criteria specified for the selected ESA (see InterQual CP references for each product). Relevant HCPCS/J- and Q-codes are provided in the policy for billing/reference.
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