J7172, Injection, marstacimab-hncq, 0.5 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
6 Active Policies
ARKBLUE-ANTI-TISSUE-FACTOR-PATHWAY-INHIBITORS-MARSTACIMA-EA195BCBBF, Anti-tissue Factor Pathway Inhibitors [Marstacimab-hncq (e.g., Hympavzi) and Concizumab-mtci (e.g., Alhemo)]
AR
BCBSLA-00924-D8BEAA208D, 00924 marstacimab-hncq (Hympavzi)
LA
POINT32HEALTH-MDMNG-12961, Hympavzi (marstacimab-hncq)
MULTI
POINT32HEALTH-MDMNG-12971, Hympavzi (marstacimab-hncq)
Related Codes
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