Prior Auth Required

10322 - expanded access. Lancet. 2022 Jan 22;399( ):372-383. doi: 10.1016/ -6736(21) -1. PMID

This procedure appears on the selected insurer prior authorization source.

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Procedure / Serviceexpanded access. Lancet. 2022 Jan 22;399( ):372-383. doi: 10.1016/ -6736(21) -1. PMID
Procedure / Service Description

4 Fumagalli F, Calbi V, Natali Sora MG, et al. Lentiviral haematopoietic stem-cell gene therapy for early-onset 11/23 - 4 Fumagalli F, Calbi V, Natali Sora MG, et al. Lentiviral haematopoietic stem-cell gene therapy for early-onset 11/23 metachromatic leukodystrophy: long-term results from a non-randomised, open-label, phase 1/2 trial and expanded access. Lancet. 2022 Jan 22;399(10322):372-383. doi: 10.1016/S0140-6736(21)02017-1. PMID: 35065785; PMCID: PMC8795071. 5 Boucher AA, Miller W, Shanley R, Ziegler R, Lund T, Raymond G, et al. Long-term outcomes after allogeneic 2015 3/2024

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  • Confirm benefit details
  • Submit clinical notes if requested by the plan
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  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.