Harvard Pilgrim has established a medical policy for the injectable/intravenous medication Reclast (zoledronic acid) and will now cover the use of Reclast for the following medically necessary conditions, effective for claims processed as of April 1, 2015:
- Treatment and prevention of postmenopausal osteoporosis
- Treatment to increase bone mass in men with osteoporosis
- Treatment and prevention of glucocorticoid-induced osteoporosis
- Treatment of Paget’s disease of bone in men and women
- Prevention or treatment of osteoporosis in men with prostate cancer during androgen deprivation therapy
Prior authorization is not required for Reclast unless delivery of this drug is in the home setting by a homecare vendor. For more information on coverage of Reclast, including coding information, please refer to the Reclast Medical Policy.