PACE

PROVIDER BULLETIN

March 26, 2004

Renagel®

 

 

 

 

Effective Monday, March 29, 2004 all claims for sevalamer hydrochloride (Renagel®) will be denied at the point of sale. The denied claim response will be the PACE DUR error message “706 CH”; NCPDP error message “88 CH” accompanied by instructions to “Call the Help Desk”.

 

Medical exceptions for Renagel® will only be approved following receipt of documentation from the prescriber substantiating:

 

1.      A prior trial of phosphate lowering therapy with an inability to control phosphate.

 

2.      A calcium phosphate product equal to or greater than 70mg²/dl².

 

NOTE: Approved Renagel® medical exceptions will be for a maximum of 4800mg (6 capsules) per day.

 

Program Representatives are NOT authorized to grant medical exceptions in the absence of this documentation.

 

 

 

 

Questions may be directed to Provider Services at

1-800-835-4080.

 

 

PPB-04-007