- Prior Authorization: Familial Amyloid Polyneuropathy (FAP):
Documented Diagnosis: Yes
Medical Test Required: Yes
Age Requirement: >= 18
Duration: 6 Month(s)
Reauthorization Required: Yes
- Familial Amyloid Polyneuropathy (FAP):
Age Requirement: >= 18
Duration: 6 Month(s)
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: Yes
Specialist Type(s): Neurologist
Reauthorization Required: Yes
Duration of Reauthorization: = 6 month(s)
Diagnosis Types: hATTR Amyloidosis with Polyneuropathy
Required Documentation: 3 of Biopsy results;Documentation of a pathogenic ttR mutation;Documentation of amyloid deposits
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