Clinical Updates for Claims and Medical Management Professionals
November 2008
Welcome to the latest edition of PeerPoints, focused on helping claims and utilization review managers make informed claims decisions.
In this issue:
When Renal Artery Stenosis Screening is Medically Necessary
Renal artery stenosis is a common cause of hypertension, most commonly causing a worsening of blood pressure control in patients with underlying essential hypertension. It also commonly causes progressive renal disease and is likely to be the third most common cause of end-stage renal disease, following diabetes and hypertension.
Diagnosing and Treating Circadian Sleep Disorders
A 23-year-old male who complains of insomnia has difficulty falling asleep at night and continually arrives at work at 11:30 a.m. when the employer work day starts at 8 a.m. Does the patient have depression, situational insomnia, obstructive sleep apnea with daytime hypersomnia, a true circadian rhythm disturbance or does he simply prefer to start work at 11:30 a.m.?
Avastin (Bevacizumab) Therapy in Oncology
Bevacizumab (Genentech brand name Avastin) is a targeted drug therapy with a growing number of indications in oncology. It is a recombinant humanized monoclonal antibody targeting vascular endothelial growth factor (VEGF). Increased VEGF serum levels correlate with lower survival rates and tumors require new blood vessel growth (neovascularization) to grow and metastasize, which the drug inhibits.
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