Deep brain stimulation (treatment-refractory anorexia).Chromium for the treatment of binge eating disorder.Cholinesterase inhibitors (e.g., donepezil) for the treatment of anorexia.Cannabinoids for the treatment of anorexia nervosa.Bupropion (Zyban), lithium, and naltrexone for the treatment of bulimia and binge eating disorder (bupropion only).Bright light therapy for the treatment of eating disorders (including light therapy for the treatment of night eating syndrome).Bisphosphonates and other anti-resorptive agents in the management of osteopenia in anorexic members.Acamprosate calcium (Campral) for the treatment of binge-eating disorder.Serotonin transporter gene (5-HTTLPR) polymorphism testing (for anorexia and bulimia).Routine screening of asymptomatic adolescents and adults for eating disorders.Measurement of serum concentration of brain derived neurotrophic factor (for anorexia).Measurement of plasma levels of polyunsaturated fatty acids.Measurement of plasma levels of adiponectin as a prognostic biomarker for bulimia.Measurement of plasma levels of hypothalamic neuropeptides (e.g., kisspeptin, nesfatin-1, phoenixin, and spexin) (for anorexia).Measurement of blood levels of peripheral brain derived neurotrophic factor (BDNF) (for bulimia).Individual Optimal Nutrition (ION) analysis/profile.Evaluation of melanocortin 4 receptor gene (MC4R) coding variants and mutations (for binge eating disorder).Evaluation of genetic polymorphisms (for binge eating disorder).Estrogen receptor 1 gene (ESR1) polymorphism testing (for anorexia).Electroencephalography (EEG) for the management of bulimia and binge-eating disorder.Catechol-O-methyltransferase (COMT) Val158Met polymorphism genotyping.Brain imaging (e.g., MRI, PET and SPECT).Blood-based serotoninergic biomarkers for tailoring treatment in bulimia.Enteral nutrition as a last resort for the treatment of anorexia (see CPB 0061 - Nutritional Support).įootnote1* Note: Coverage of particular drugs within each class may be subjected to formulary restrictions, where applicable.Īetna considers the following services/procedures experimental and investigational for the diagnosis and treatment of anorexia and bulimia because of insufficient evidence in the peer-reviewed literature:.Psychotherapy (e.g., cognitive behavioral therapy, family psychotherapy, interpersonal psychotherapy, and psychodynamic psychotherapy).Please check benefit plan descriptions.) Footnote1*
Pharmacotherapy for the treatment of binge-eating disorder (e.g., lisdexamfetamine dimesylate (Vyvanse)) ( Note: Coverage may be excluded under plans that exclude coverage of medications to decrease or increase weight.Pharmacotherapy for the treatment of bulimia (e.g., selective serotonin reuptake inhibitors such as fluoxetine, tricyclic anti-depressants, trazodone, topiramate) Footnote1*.Pharmacotherapy for the treatment of anorexia (e.g., selective serotonin reuptake inhibitors and anti-psychotics) Footnote1*.Nutritional counseling (see CPB 0049 - Nutritional Counseling).Psychiatric / psychological consultation and testing.Medical evaluation (complete medical history and physical examination).Bone density measurement (for evaluation of anorexic members) (see CPB 0134 - Bone Mass Measurements).Blood count and serum chemistry (e.g., CBC, electrolytes, BUN/creatinine).Number: 0511 Table Of Contents Policy Applicable CPT / HCPCS / ICD-10 Codes Background ReferencesĪetna considers screening for eating disorders in adolescents and adults experimental and investigational because its clinical value has not been established.Īetna considers the following services and procedures medically necessary for the management of members with anorexia or bulimia:
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