C9076 prior authorization | Anthem Blue Cross and Blue Shield Nevada

C9076, Lisocabtagene maraleucel, up to 110 million autologous anti-CD19 CAR-positive viable T cells, including leukapheresis and dose preparation procedures, per therapeutic dose, is on the Anthem Blue Cross and Blue Shield Nevada prior authorization list. Not a coverage or referral decision.

Code: C9076
Description: Lisocabtagene maraleucel, up to 110 million autologous anti-CD19 CAR-positive viable T cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Source: Nevada Prior Authorization List, Pg 139 Original policy

Anthem Blue Cross and Blue Shield Nevada prior authorization

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