Connecticut
Provider Communications
Specialty pharmacy updates
Important to note: Currently, your patients may be receiving these medications without prior authorization. As of the effective date below, you may be required to request prior authorization review for your patients’ continued use of these medications.
Including the national drug code (NDC) code on your claim may help expedite claim processing of drugs billed with a not otherwise classified (NOC) code.
Clinical Criteria update: Effective January 1, 2023, clinical criteria naming will be changed from ING-CC-XXXX to CC-XXXX; however, the content within the documents will remain unchanged.
Prior authorization updates
Correction: In the August 2022 edition of Provider News, we published prior authorization updates for the drug Pluvicto (lutetium lu 177 vipivotide tetraxetan). Please be advised that the effective date for this update has been changed:
- Previous effective date: November 1, 2022
- Updated effective date: February 1, 2023
Access our Clinical Criteria to view the complete information for these prior authorization updates.
Clinical Criteria |
Drug |
HCPCS or CPT® code(s) |
CC-0118* |
Pluvicto (lutetium lu 177 vipivotide tetraxetan) |
A9607 |
* Oncology use is managed by AIM.
Featured In:
January 2023 Provider Newsletter - Connecticut