Anthem Blue Cross Blue Shield of Georgia prior authorization Q2053

Anthem Blue Cross Blue Shield of Georgia prior authorization for Q2053: Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose

Code: Q2053
Description: Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Source: Standard Local Prior Authorization Code List, Pg 118 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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