If you are on a BCBS-MI Medicaid plan and meet the BMI and clinical criteria, your prescriber can submit a PA for Wegovy under the preferred AOM benefit
Key index paths: Neuropathy, neuropathic main term subterm peripheral subterm by etiology (alcoholic, diabetic, drug-induced, hereditary, idiopathic, inflammatory, ischemic, toxic) Neuropathy, peripheral, diabetic see E08E13 with .40.49 Polyneuropathy main term subterms by etiology (alcoholic G62.1, critical illness G62.81, diabetic [see Diabetes, with neuropathy], drug-induced G62.0, hereditary G60.x, idiopathic G60.9, inflammatory G61.x, radiation G62.82, toxic G62.2) Syndrome, carpal tunnel G56.0- Syndrome, tarsal tunnel G57.5- Syndrome, Guillain-Barr G61.0 Neuropathy, CIDP G61.81 Disease, Charcot-Marie-Tooth G60.0 Meralgia paresthetica G57.1- Neuralgia, post-herpetic B02.29 (other PHN) or B02.22 (trigeminal) Degeneration, subacute combined G32.0 Dysautonomia G90.1 (familial), G90.09 (other idiopathic) Syndrome, Refsum G60.1 Coder Note When the index leads to see also Diabetes, with, neuropathy always confirm documentation of the specific type of diabetes (Type 1, Type 2, secondary, drug-induced) before selecting the E-code subcategory
The weight-related conditions that make obese people eligible include type 2 diabetes, prediabetes, high blood pressure, dyslipidaemia (unbalanced or unhealthy cholesterol levels), obstructive sleep apnoea and heart disease
To begin, you complete a medical assessment, this includes entering weight loss goals and your health history
