J1610, Injection, glucagon hydrochloride, per 1 mg
HCPCS/CPT
Prior Authorization
Prior Auth Required
Conditional coverage; review criteria to confirm PA need (medium confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
5 Active Policies
BCBSLA-00575-8B4076D09E, 00575 Basal Insulin/Glucagon Like Peptide (GLP)-1 Agonist Combination Products--Retired Policy
LA
BCBSMA-056-0E329073B9, Glucagon-like Peptide-1 (GLP-1) Receptor Agonists and Related Drugs for the Treatment of Type 2 Diabetes
MA
POINT32HEALTH-PMNG-15701, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists
MULTI
HEALTHNET_OR-HNOR-GLUCAGON-LIKE-PEPTIDE-1-GLP-1-RECEPTOR-AGONISTS-OR-CP-CP-736BE8CD9F
Related Codes
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