Limited Use Note(s) |
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LIPASE & AMYLASE & PROTEASE35000 & 35700 & 2240 Units
Reason For Use Code | Clinical Criteria |
---|---|
124 | Replacement therapy for pancreatic insufficiency secondary to pancreatic surgery (resection). |
LU Authorization Period: Indefinite | |
125 | Replacement therapy for pancreatic insufficiency due to chronic pancreatitis. |
LU Authorization Period: Indefinite | |
126 | Replacement therapy for pancreatic insufficiency due to carcinoma of the pancreas. |
LU Authorization Period: Indefinite | |
225 | Replacement therapy for pancreatic insufficiency due to cystic fibrosis. |
LU Authorization Period: Indefinite |