Reply To: Reimbursement for infliximab

[Anonymous]

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).