Documentation that the patient declined change in medication or alternative therapies were unavailable, has documented contraindications, or has not been treated with a systemic medication for at least six consecutive months (e.g., experienced adverse effects or lack of efficacy with all other therapy options) in order to achieve better disease control as measured by pga, bsa, pasi, or dlqi

Code type

HCPCS Level II

Coverage

Carrier judgment

BETOS category

Z2

Pricing indicator

00

Effective date

20190101