Prior Auth Required

90399 - * Unlisted IVIG* IMMUNE GLOBULIN 01/01/1999 n/a

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Service* Unlisted IVIG* IMMUNE GLOBULIN 01/01/1999 n/a
Procedure / Service Description

HCPCS/ DRUG NAME GENERIC/ ALTERNATE DRUG NAME PADP CE/ SAD**/ DRUG CODE COMMENTS - 90284 HYQVIA IMMUNE GLOBULIN x SAD** 10/06/2014 n/a 90378 SYNAGIS PALIVIZUMAB 01/01/2008 n/a 90399* Unlisted IVIG* IMMUNE GLOBULIN 01/01/1999 n/a A9156* ORAL ORAL MUCOADHESIVE, ANY TYPE* BOTH*** 10/01/2023 n/a A9513 LUTATHERA LUTETIUM LU 177 x 01/26/2018 n/a

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