BCBSGa expands specialty pharmacy prior authorization list

Effective for dates of service on and after January 1, 2019, the following specialty pharmacy codes from new or current medical policies or clinical UM guidelines will be included in our prior authorization review process.

Please note, inclusion of NDC code on your claim will shorten the claim processing of drugs billed with a Not Otherwise Classified (NOC) code.

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 January 1, 2019:

Coverage or Clinical UM Guideline	HCPCS/CPT Code	NDC Code	Drug	Comments
DRUG.00096	J3490 J3590	62064-0122-02	Trogarzo™	New policy