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Anthem Blue Cross Blue Shield of Colorado prior authorization, page 73

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
J7202Injection, factor ix, albumin fusion protein, (recombinant), idelvion, 1 i.u.Colorado Prior Authorization List, Pg 159 Original policy
J7203Injection Factor IX, (antihemophilic factor, recombinant), glycopegylated, (Rebinyn), 1 IUColorado Prior Authorization List, Pg 159 Original policy
J7204Injection, Factor VIII, antihemophilic factor (recombinant), (Esperoct), glycopegylated-exei, per IUColorado Prior Authorization List, Pg 159 Original policy
J7205Injection, factor viii fc fusion (recombinant), per iuColorado Prior Authorization List, Pg 159 Original policy
J7207Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u.Colorado Prior Authorization List, Pg 159 Original policy
J7208Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u.Colorado Prior Authorization List, Pg 159 Original policy
J7209Injection, factor viii, (antihemophilic factor, recombinant), (nuwiq), 1 i.u.Colorado Prior Authorization List, Pg 159 Original policy
J7210Injection, Factor VIII, (antihemophilic factor, recombinant), (Afstyla), 1 IUColorado Prior Authorization List, Pg 159 Original policy
J7211Injection, Factor VIII, (antihemophilic factor, recombinant), (Kovaltry), 1 IUColorado Prior Authorization List, Pg 159 Original policy
J7212Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgramColorado Prior Authorization List, Pg 159 Original policy
J7213Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.Colorado Prior Authorization List, Pg 159 Original policy
J7214Injection, Factor VIII/von Willebrand factor complex, recombinant (Altuviiio), per Factor VIII IUColorado Prior Authorization List, Pg 159 Original policy
J7311Injection, fluocinolone acetonide, intravitreal implant (Retisert), 0.01 mgColorado Prior Authorization List, Pg 159 Original policy
J7312Injection, dexamethasone, intravitreal implant, 0.1 mgColorado Prior Authorization List, Pg 159 Original policy
J7313Injection, fluocinolone acetonide, intravitreal implant (Iluvien), 0.01 mgColorado Prior Authorization List, Pg 159 Original policy
J7314Injection, fluocinolone acetonide, intravitreal implant (Yutiq), 0.01 mgColorado Prior Authorization List, Pg 159 Original policy
J7330Cultured Chondrocytes ImplntColorado Prior Authorization List, Pg 159 Original policy
J7340Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 mlColorado Prior Authorization List, Pg 159 Original policy
J7351Injection, bimatoprost, intracameral implant, 1 microgramColorado Prior Authorization List, Pg 159 Original policy
J7352Afamelanotide implant, 1 mgColorado Prior Authorization List, Pg 159 Original policy
J7353Anacaulase-bcdb, 8.8% gel, 1 gmColorado Prior Authorization List, Pg 159 Original policy
J7354Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)Colorado Prior Authorization List, Pg 159 Original policy
J7355Injection, travoprost, intracameral implant, 1 mcgColorado Prior Authorization List, Pg 159 Original policy
J7356Injection, foscarbidopa 0.25 mg/foslevodopa 5 mgColorado Prior Authorization List, Pg 159 Original policy
J7402Mometasone furoate sinus implant, (sinuva), 10 microgramsColorado Prior Authorization List, Pg 159 Original policy
J7686Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mgColorado Prior Authorization List, Pg 159 Original policy
J9011Injection, datopotamab deruxtecan-dlnk, 1 mgColorado Prior Authorization List, Pg 159 Original policy
J9015Injection, aldesleukin, per single use vialColorado Prior Authorization List, Pg 159 Original policy
J9021Injection, asparaginase, recombinant, (rylaze), 0.1 mgColorado Prior Authorization List, Pg 159 Original policy
J9022Injection, atezolizumab, 10 mgColorado Prior Authorization List, Pg 159 Original policy
J9023Injection, avelumab, 10 mgColorado Prior Authorization List, Pg 159 Original policy
J9024Injection, atezolizumab, 5 mg and hyaluronidase-tqjsColorado Prior Authorization List, Pg 159 Original policy
J9026Injection, tarlatamab-dlle, 1 mgColorado Prior Authorization List, Pg 160 Original policy
J9028Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgramColorado Prior Authorization List, Pg 160 Original policy
J9029Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic doseColorado Prior Authorization List, Pg 160 Original policy
J9032Injection, belinostat, 10 mgColorado Prior Authorization List, Pg 160 Original policy
J9033Injection, bendamustine hydrochloride, 1 mgColorado Prior Authorization List, Pg 160 Original policy
J9034Injection, bendamustine hcl (bendeka), 1 mgColorado Prior Authorization List, Pg 160 Original policy
J9035Bevacizumab injectionColorado Prior Authorization List, Pg 160 Original policy
J9036Injection, bendamustine hydrochloride, (Belrapzo), 1 mgColorado Prior Authorization List, Pg 160 Original policy
J9038Injection, axatilimab-csfr, 0.1 mgColorado Prior Authorization List, Pg 160 Original policy
J9039Injection, blinatumomab, 1 microgramColorado Prior Authorization List, Pg 160 Original policy
J9042Injection, brentuximab vedotin, 1 mgColorado Prior Authorization List, Pg 160 Original policy
J9043Injection, cabazitaxel, 1 mgColorado Prior Authorization List, Pg 160 Original policy
J9047Injection, carfilzomib, 1 mgColorado Prior Authorization List, Pg 160 Original policy
J9055Cetuximab injectionColorado Prior Authorization List, Pg 160 Original policy
J9056Injection, bendamustine hydrochloride (vivimusta), 1 mgColorado Prior Authorization List, Pg 160 Original policy
J9057Injection, copanlisib, 1 mgColorado Prior Authorization List, Pg 160 Original policy
J9061Injection, amivantamab-vmjw, 2 mgColorado Prior Authorization List, Pg 160 Original policy
J9063Injection, mirvetuximab soravtansine-gynx, 1 mgColorado Prior Authorization List, Pg 160 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.

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