Blue Cross of Kansas

[Phasmid]

Checking with doc's office on the status of my son's case, the office gal told me that they are waiting for my son's doc to write a letter to Anthem BC, but feel that they have a good case. I asked why they thought that, since nobody seems to be covering. She told me that Blue Cross of Kansas recognizes PANDAS as a qualifying diagnosis. This is the first I have heard of any insurance company covering for PANDAS, without some other immune deficiency diagnosis.

 

Anyone else know about this???

 

Oh, and the link below is to the page discussing IVIG. In here, they clearly state that specific immune deficiency, the failure to make antibodies against pneumococcal bacteria (Strep and Haemophilus influenza) is grounds for using IVIG! I think that a condition is that an attempt to control infections (sinusitis is specified) is made first though. Those of you who have documented (toxin positive) antibiotic associated Clostridium difficile colonization should keep good records. We do have C. diff. history, so if my son can get off antibiotics with IVIG I would choose this route.

 

http://www.bcbsks.co..._2011-01-28.pdf

 

I am confused, as I just re-read the page on this insurance carrier website on IVIG. The info on PANDAS is this:

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections

 

The National Advisory Committee on Blood and Blood Products and Canadian Blood Services convened a panel of national experts to develop an evidence-based practice guideline on the use of IVIG for neurologic conditions. (25) Recommendations for use of IVIG were made for 14 conditions, including pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). The Panel emphasized that this syndrome is not well understood and diagnosis of PANDAS requires expert consultation. The optimum dose and duration of treatment is uncertain. The evidence review examining IVIg for PANDAS identified 1 RCT of 29 children who had new or severe exacerbations of obsessive-compulsive disorder (OCD) or tic disorder after streptococcal infections randomly assigned to IVIg plasma exchange or placebo. At 1-month follow-up, IVIg and plasma exchange had no significant differences and showed significant improvement in obsessive-compulsive symptoms. The improvement in symptoms was evident at 1-year follow-up. (73) Given that there is only 1 small study, there are insufficient data to support the use of IVIg for PANDAS.

 

Edited February 9, 2011 by Phasmid