Neurology - Kebilidi®
EVICORE-EMBARC-F9E4BECD
Covered: one-time (per lifetime) single‑dose intraputaminal Kebilidi (eladocagene exuparvovec) for AADC deficiency when ALL criteria are met: patient ≥16 months with skull maturity on neuroimaging, biallelic pathogenic DDC variants, decreased plasma AADC activity, persistent symptoms despite ≥1 standard therapy, no prior Kebilidi, prescribed by a neurologist/neurosurgeon, and administered as four intraputaminal infusions (total 1.8×10^11 vector genomes) in a stereotactic neurosurgical center using an FDA‑authorized cannula and appropriate infusion pump. Excluded if any criteria are unmet; required documentation/verification includes neuroimaging, genetic testing, AADC enzyme assay, prior treatment history, claims verification of prior Kebilidi, and dosing/administration verification by the Medical Director.
"Treatment of aromatic L-amino acid decarboxylase (AADC) deficiency (FDA-approved indication for adult and pediatric patients)."