Effective for dates of service on and after November 1, 2019, the following non-oncology specialty pharmacy codes from current clinical criteria will be included in our pre-service clinical review process.

 

Please note: inclusion of NDC code on claims will help expedite claim processing of drugs billed with a not otherwise classified (NOC) code.

 

Pre-service clinical review of non-oncology specialty pharmacy drugs will be managed by Anthem’s medical specialty drug review team. Oncology drugs will be managed by AIM Specialty Health® (AIM), a separate company.

 

Medical Policy or Clinical UM Guideline

HCPCS or CPT Codes

NDC Codes

Drug

ING-CC-0050

J3490

J3590

00074-2042-01

00074-2042-02

Skyrizi™



Featured In:
August 2019 Anthem New Hampshire Provider News