Prior Authorization

Growth Hormone

Documentation Needed for Growth Hormone with diagnosis of Turner Syndrome & Prader Willi Syndrome

1. A thorough pre-treatment history & physical to include:

1. Confirmed diagnosis (positive chromosome study)
2. If over 5 years old, what percentile does patient fit into
3. If under 5 years, how many standard deviations in height is patient
4. Growth hormone stimulation test NOT REQUIRED for these conditions
5. Need annual growth rate
6. All patients 14 years or older must have current bone age report

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