Talk to Us

Anthem Blue Cross Blue Shield of Colorado prior authorization, page 68

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
J0013Esketamine, nasal spray, 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0129Injection, abatacept, 10 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)Colorado Prior Authorization List, Pg 154 Original policy
J0135Adalimumab injectionColorado Prior Authorization List, Pg 154 Original policy
J0139Injection, adalimumab, 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0172Injection, aducanumab-avwa, 2 mgColorado Prior Authorization List, Pg 154 Original policy
J0174Lecanemab-irmb, for intravenous injection, 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0175Injection, donanemab-azbt, 2 mgColorado Prior Authorization List, Pg 154 Original policy
J0177Injection, aflibercept HD, 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0178Injection, aflibercept, 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0179Injection, brolucizumab-dbll, 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0180Agalsidase beta injectionColorado Prior Authorization List, Pg 154 Original policy
J0202Injection, alemtuzumab, 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0208Injection, sodium thiosulfate (Pedmark), 100 mgColorado Prior Authorization List, Pg 154 Original policy
J0217Injection, velmanase alfa-tycv, 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0218Injection, olipudase alfa-rpcp, 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0219Injection, avalglucosidase alfa-ngpt, 4 mgColorado Prior Authorization List, Pg 154 Original policy
J0221Injection, alglucosidase alfa, (Lumizyme), 10 mgColorado Prior Authorization List, Pg 154 Original policy
J0222Injection, Patisiran, 0.1 mgColorado Prior Authorization List, Pg 154 Original policy
J0223Injection, givosiran, 0.5 mgColorado Prior Authorization List, Pg 154 Original policy
J0224Injection, lumasiran, 0.5 mColorado Prior Authorization List, Pg 154 Original policy
J0225Injection, vutrisiran, 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0256Injection, alpha 1-proteinase inhibitor (human), not otherwise specified, 10 mgColorado Prior Authorization List, Pg 154 Original policy
J0257Injection, alpha 1 proteinase inhibitor (human), (GLASSIA), 10 mgColorado Prior Authorization List, Pg 154 Original policy
J0456AzithromycinColorado Prior Authorization List, Pg 154 Original policy
J0485Injection, belatacept, 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0490Injection, belimumab, 10 mgColorado Prior Authorization List, Pg 154 Original policy
J0491Injection, anifrolumab-fnia, 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0517Injection, benralizumab, 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0558Injection, penicillin g benzathine and penicillin g procaine, 100,000 unitsColorado Prior Authorization List, Pg 154 Original policy
J0561Injection, penicillin g benzathine, 100,000 unitsColorado Prior Authorization List, Pg 154 Original policy
J0565Injection, bezlotoxumab, 10 mgColorado Prior Authorization List, Pg 154 Original policy
J0567Injection, cerliponase alfa, 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0584Injection, burosumab-twza 1 mgColorado Prior Authorization List, Pg 154 Original policy
J0585Injection, Onabotulinumtoxina, 1 UnitColorado Prior Authorization List, Pg 154 Original policy
J0586Injection, Abobotulinumtoxina, 5 UnitsColorado Prior Authorization List, Pg 155 Original policy
J0587Injection, Rimabotulinumtoxinb, 100 UnitsColorado Prior Authorization List, Pg 155 Original policy
J0588Injection, incobotulinumtoxinA, 1 unitColorado Prior Authorization List, Pg 155 Original policy
J0589Injection, daxibotulinumtoxina-lanm, 1 unitColorado Prior Authorization List, Pg 155 Original policy
J0593Injection, lanadelumab-flyo, 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered)Colorado Prior Authorization List, Pg 155 Original policy
J0596Injection, c1 esterase inhibitor (recombinant), ruconest, 10 unitsColorado Prior Authorization List, Pg 155 Original policy
J0597Injection, c-1 esterase inhibitor (human), berinert, 10 unitsColorado Prior Authorization List, Pg 155 Original policy
J0598Injection, c-1 esterase inhibitor (human), cinryze, 10 unitsColorado Prior Authorization List, Pg 155 Original policy
J0599Injection, C-1 esterase inhibitor (human), (Haegarda), 10 unitsColorado Prior Authorization List, Pg 155 Original policy
J0614Injection, treosulfan, 50 mgColorado Prior Authorization List, Pg 155 Original policy
J0638Injection, canakinumab, 1 mgColorado Prior Authorization List, Pg 155 Original policy
J0641Injection, levoleucovorin, not otherwise specified, 0.5 mgColorado Prior Authorization List, Pg 155 Original policy
J0642Injection, levoleucovorin (khapzory), 0.5 mgColorado Prior Authorization List, Pg 155 Original policy
J0687Injection, cefazolin sodium (WG Critical Care), not therapeutically equivalent to J0690, 500 mgColorado Prior Authorization List, Pg 155 Original policy
J0688Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mgColorado Prior Authorization List, Pg 155 Original policy
J0689Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mgColorado Prior Authorization List, Pg 155 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