Effective for dates of service on and after May 1, 2021, the following specialty pharmacy codes from current or new Clinical Criteria documents will require prior authorization.

 

Visit the Clinical Criteria website to search for specific clinical criteria. Please note, these codes are specific to Agents for Iron Deficiency Anemia. The Clinical Criteria indicated below can be found at: https://www.anthem.com/ms/pharmacyinformation/Agents-for-Iron-Deficiency-Anemia.pdf.

 

Clinical Criteria

HCPCS or CPT® code(s)

Drug

ING-CC-0182

J1756

Venofer

ING-CC-0182

J2916

Ferrlecit

ING-CC-0182

J1750

Infed

ING-CC-0182

J1439

Injectafer

ING-CC-0182

Q0138

Feraheme

ING-CC-0182

J1437

Monoferric

 

If you have questions about this communication or need further assistance, contact your local Provider Relations representative or call Provider Services at 1-844-396-2330.

 

 

ANV-NU-0201-21



Featured In:
April 2021 Anthem Provider News and Important Updates -- Nevada