Expert Nurse
Avatar photoVirginia Seery

    We have had some issues getting infliximab approved for colitis, but as Kathleen said, it is often because the wrong diagnosis code or clinical information is presented. When I have done a peer to peer review because of a denial it has always been approved. Agree that using diagnosis code for colitis helps (K 51.50 has worked for us).

    On the other hand, I have not been able to get vedolizumab approved (when a pt is steroid refractory and not improving with infliximab).