ND Committee Review
Internal Medical Policy Committee 7-16-2019 Adopted policy effective 7-15-2020
Internal Medical Policy Committee 9-26-2019 Added new code J3111
Internal Medical Policy Committee 9-21-2020 Added additional diagnosis codes
Internal Medical Policy Committee 1-19-2021 Added one additional 'or' criteria 'Individual is 40 years of age and older, has BMD T-score between -1 and -2.5, and has a history of glucocorticoid use for at least three (3) months at a dose of 5mg per day or more of prednisone (or equivalent)'
Internal Medical Policy Committee 3-23-2022 Annual review, no clinical content change
Internal Medical Policy Committee 3-23-2023
Effective May 01, 2023
- Updated
experimental/investigational statement
