Talk to Us

Anthem Blue Cross and Blue Shield Nevada prior authorization, page 70

CPT code lookup

Each row is one code from the public prior authorization list. The description is the procedure or service name on that source row. This is not a coverage decision.

Prior authorization codes

Prior authorization codes
CodeDescriptionSource
J0882Injection, darbepoetin alfa, 1 mcg (for ESRD on dialysis)Nevada Prior Authorization List, Pg 147 Original policy
J0885Injection, epoetin alfa, (for non-ESRD use), 1000 unitsNevada Prior Authorization List, Pg 147 Original policy
J0887Injection, epoetin beta, 1 microgram, (for esrd on dialysis)Nevada Prior Authorization List, Pg 147 Original policy
J0888Injectin, epoetin beta, 1 microgram, (for non esrd use)Nevada Prior Authorization List, Pg 147 Original policy
J0896Injection, luspatercept-aamt, 0.25 mgNevada Prior Authorization List, Pg 147 Original policy
J0897Injection, denosumab, 1 mgNevada Prior Authorization List, Pg 148 Original policy
J1072Injection, testosterone cypionate (Azmiro), 1 mgNevada Prior Authorization List, Pg 148 Original policy
J1073Testosterone pellet, implant, 75 mgNevada Prior Authorization List, Pg 148 Original policy
J1203Injection, cipaglucosidase alfa-atga, 5 mgNevada Prior Authorization List, Pg 148 Original policy
J1290Injection, ecallantide, 1 mgNevada Prior Authorization List, Pg 148 Original policy
J1299Injection, eculizumab, 2 mgNevada Prior Authorization List, Pg 148 Original policy
J1300Injection, eculizumab, 10 mgNevada Prior Authorization List, Pg 148 Original policy
J1301Injection, edaravone, 1 mgNevada Prior Authorization List, Pg 148 Original policy
J1302Injection, sutimlimab-jome, 10 mgNevada Prior Authorization List, Pg 148 Original policy
J1303Injection, ravulizumab-cwvz, 10 mgNevada Prior Authorization List, Pg 148 Original policy
J1304Injection, tofersen, 1 mgNevada Prior Authorization List, Pg 148 Original policy
J1305Injection, evinacumab-dgnb, 5 mgNevada Prior Authorization List, Pg 148 Original policy
J1306Injection, inclisiran, 1 mgNevada Prior Authorization List, Pg 148 Original policy
J1307Injection, crovalimab-akkz, 10 mgNevada Prior Authorization List, Pg 148 Original policy
J1322Injection, elosulfase alfa, 1mgNevada Prior Authorization List, Pg 148 Original policy
J1323Injection, elranatamab-bcmm, 1 mgNevada Prior Authorization List, Pg 148 Original policy
J1325Epoprostenol InjectionNevada Prior Authorization List, Pg 148 Original policy
J1326Injection, zolbetuximab-clzb, 2 mgNevada Prior Authorization List, Pg 148 Original policy
J1335Injection, ertapenem sodium, 500 mgNevada Prior Authorization List, Pg 148 Original policy
J1411Injection, etranacogene dezaparvovec-drlb, per therapeutic doseNevada Prior Authorization List, Pg 148 Original policy
J1412Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomesNevada Prior Authorization List, Pg 148 Original policy
J1413Injection, delandistrogene moxeparvovec-rokl, per therapeutic doseNevada Prior Authorization List, Pg 148 Original policy
J1414Injection, fidanacogene elaparvovec-dzkt, per therapeutic doseNevada Prior Authorization List, Pg 148 Original policy
J1426Injection, casimersen, 10 mgNevada Prior Authorization List, Pg 148 Original policy
J1427Injection, viltolarsen, 10 mgNevada Prior Authorization List, Pg 148 Original policy
J1428Injection, eteplirsen, 10 mgNevada Prior Authorization List, Pg 148 Original policy
J1429Injection, golodirsen, 10 mgNevada Prior Authorization List, Pg 148 Original policy
J1437Injection, ferric derisomaltose, 10 mgNevada Prior Authorization List, Pg 148 Original policy
J1438Etanercept InjectionNevada Prior Authorization List, Pg 148 Original policy
J1439Injection, ferric carboxymaltose, 1mgNevada Prior Authorization List, Pg 148 Original policy
J1440Fecal microbiota, live - jslm, 1 mlNevada Prior Authorization List, Pg 148 Original policy
J14425G-CSFexcludes biosimilars, 1 microgramNevada Prior Authorization List, Pg 148 Original policy
J1447Injection, tbo-filgrastim, 1 microgramNevada Prior Authorization List, Pg 148 Original policy
J1448Injection, trilaciclib, 1 mgNevada Prior Authorization List, Pg 148 Original policy
J1449Injection, eflapegrastim-xnst, 0.1 mgNevada Prior Authorization List, Pg 148 Original policy
J1450FluconazoleNevada Prior Authorization List, Pg 148 Original policy
J1454Injection, fosnetupitant 235 mg and palonosetron 0.25 mgNevada Prior Authorization List, Pg 148 Original policy
J1458INJECTION, GALSULFASE, 1 MGNevada Prior Authorization List, Pg 148 Original policy
J1459Injection, immune globulin (Privigen), intravenous, nonlyophilized (e.g., liquid), 500 mgNevada Prior Authorization List, Pg 148 Original policy
J1460Gamma Globulin 1 Cc InjNevada Prior Authorization List, Pg 148 Original policy
J1551Injection, immune globulin (cutaquig), 100 mgNevada Prior Authorization List, Pg 148 Original policy
J1552Injection, immune globulin (alyglo), 500 mgNevada Prior Authorization List, Pg 148 Original policy
J1554Injection, immune globulin (asceniv), 500 mgNevada Prior Authorization List, Pg 148 Original policy
J1555Injection, immune globulin (Cuvitru), 100 mgNevada Prior Authorization List, Pg 148 Original policy
J1556Injection, immune globulin (bivigam), 500 mgNevada Prior Authorization List, Pg 148 Original policy

Sources

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.

This website uses cookies to ensure you get the best experience on our website. Learn more