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Medical Necessity Review Required for Implantable Testosterone Pellets

Effective July 1, 2014, Horizon Blue Cross Blue Shield of New Jersey will require a medical necessity review for the use of Testopel ® or other implantable testosterone pellets. The revised medical policy establishes more precise criteria for the appropriate use of these drugs and is aligned with nationally recognized clinical criteria, current industry standards and Endocrine Society guidelines.

This revised medical policy, Implantable Testosterone Pellets (Testopel Pellets) , is available in our online Medical Policy Manual. To access this information, click the link above or navigate to the Provider Reference Materials (PRM) main page and:

  • Click Medical Policies and PreCert.
  • Click Medical Policy Manual.
  • Search for and click Implantable Testosterone Pellets (Testopel Pellets).

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been canceled or postponed, the changes will be applied to claims for dates of service on and after July 1, 2014.

TESTOPEL® is a registered trademark of Auxilium Pharmaceuticals, Inc.

Published on: April 1, 2014, 06:11 a.m. ET
Last updated on: November 24, 2020, 23:12 p.m. ET