Aetna prior authorization J9155

Aetna prior authorization for J9155: (LHRH) agents: Commercial plans — precertification required for prostate cancer only Medicare plans — precertification required for all diagnoses Firmagon (degarelix) — precertification required for Commercial members only

Code: J9155
Description: (LHRH) agents: Commercial plans — precertification required for prostate cancer only Medicare plans — precertification required for all diagnoses Firmagon (degarelix) — precertification required for Commercial members only
Source: Participating provider precertification list for Aetna, Pg 28 Original policy

Aetna prior authorization

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.