Webappropriate CPT code for the administration of the injection. In addition, submit the HCPCS Level II code for the drug. If no specific HCPCS code exists for the drug, submit J3490 … Web• Oncology Medication Clinical Coverage • Ophthalmologic Policy: Vascular Endothelial Growth ... Diagnosis . How Supplied . National Drug Code Maximum Brand Generic Allowed Actemra . tocilizumab . 20 mg/mL vials . 50242-0135-01 50242-0136-01 50242-0137-01 . 40 mL . Avastin .
Clinical Criteria - Anthem
WebThis page provides the clinical criteria documents for all injectable, infused, or implanted prescription drugs and therapies covered under the medical benefit.The effective dates for using these documents for clinical reviews are communicated through the provider notification process. WebNov 14, 2008 · Supply codes (substance/drug and amount administered) for injections and infusions are documented using a “J” code from HCPCS Level II, such as J7030 for infusion of normal saline solution, 1,000 mL. Some commercial payers do not accept the HCPCS Level II supply codes and will not reimburse for them. canon mg5670 ink cartridge
Precertification Lists - Aetna
WebDiagnosis coding under this system uses 3–7 alpha and numeric digits The ICD-10 procedure coding system uses 7 alpha or numeric digits Dotted Code: K35.3: ICD-10-CM … WebJan 1, 2024 · Participating providers are required to pursue precertification for procedures and services on the lists below. 2024 Participating Provider Precertification List – Effective date: May 1, 2024 (PDF) Behavioral health precertification list – effective date: January 1, 2024 (PDF) For Aetna’s commercial plans, there is no precertification ... WebFor select CPT codes, Availity's electronic authorization tool automatically routes you to MCG Health's website where you can document specific clinical criteria for your patient. ... To verify coverage or benefits or determine pre-certification or pre-authorization requirements for a particular member, call 1-800-676-BLUE or send an electronic ... canon mg5750 colour printing problem