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Repository Corticotropin Injection

Repository corticotropin injection may be considered medically necessary for the treatment of infantile spasms (West syndrome).
Use of repository corticotropin injection is considered investigational as a treatment of corticosteroid-responsive conditions (see Policy Guidelines section).

Except as noted above, use of repository corticotropin injection is considered investigational for conditions that are not responsive to corticosteroid therapy including, but not limited to, use in tobacco cessation, acute gout, and childhood epilepsy.

Repository corticotropin injection is considered investigational for use in diagnostic testing of adrenocortical function.

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