Effective for dates of service on and after September 1, 2018, the following specialty pharmacy codes from new or current medical policies or clinical UM guidelines will be included in our prior authorization review process.

BCBSGa’s prior authorization clinical review of these specialty pharmacy drugs will be managed by AIM Specialty Health® (AIM), a separate company.

 

The following clinical guidelines or medical policies will be effective September 1, 2018:

Medical Policy or Clinical Guideline

 

Code

 

Drug

 

Comments

CG-DRUG-44

 

 

J2507

 

 

Krystexxa®

 

 

Existing Guideline

 

CG-DRUG-89

 

 

J3490

Q9991

Q9992

 

Sublocade TM

 

 

 

New Drug to Existing Guideline



Featured In:
June 2018 BCBSGa Provider Newsletter