99499
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Key Coverage Criteria
- The use of a ketogenic diet for children and teenagers with seizures refractory to antiepileptic drugs is consideredmedically necessary.
1 Active Policy
ANTHEM-CG-MED-05 — CG-MED-05 Ketogenic Diet for Treatment of Intractable Seizures
Related Codes
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