Lipid Apheresis "Notification"
"New policy developed. LDL apheresis is covered for patients with homozygous familial hypercholesterolemia as an alternative to plasmapheresis. LDL apheresis is covered for patients with heterozygous familial hypercholesterolemia who have failed a 6-month trial of diet therapy and maximum tolerated combination drug therapy AND who meet the following FDA approved indications: (All LDL levels represent the best achievable LDL level after a program of diet and drug therapy.) 1. Functional hypercholesterolemic heterozygotes with LDL > 300 mg/dL
2. Functional hypercholesterolemic heterozygotes with LDL > 200 mg/dL AND documented coronary artery disease. LDL apheresis is not covered for all other clinical indications, with the exception of those listed above. HDL delipidation is not covered for any clinical indication. Medical Director review 11/2013. Notification given 12/31/2013 for effective date 3/11/2014."