Effective immediately, CG-DRUG 47 Level of Care was removed from the Specialty Pharmacy Clinical Site of Care > Specialty Pharmaceuticals list. In addition, the following Specialty Pharmacy codes will be removed from our existing Specialty Pharmacy level of care review process.

Medical Policy or

Clinical Guideline

Drug

Code

CG-DRUG-100  (converted from DRUG.00084)

Interferon gamma-1b (Actimmune®)

J9216

DRUG.00086

Mecasermin (Increlex®)

J2170

CG-DRUG-60

Degarelix (Firmagon®)

J9155

 



Featured In:
August 2018 Anthem Blue Cross Provider Newsletter - California