J2358, Injection, olanzapine, long-acting, 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
Key Coverage Criteria
- Coverage indication: Atypical antipsychotic injections Aristada or Zyprexa Relprevv are covered when all listed criteria are met.
2 Active Policies
HEALTHPARTNERS-CC-ENTRY-203025, Atypical antipsychotic injections (Aristada, and Zyprexa Relprevv) – Minnesota Health Care Programs
MULTI
HEALTHNET_OR-HNOR-OLANZAPINE-LONG-ACTING-INJECTION-ZYPREXA-RELPREVV-CP-PHA-60B73D9B60, Olanzapine Long-Acting Injection (Zyprexa Relprevv); CP.PHAR.292
OR
Related Codes
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