Q2042 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

Q2042, Tisagenlecleucel, up to 600 million CAR- positive viable T cells, including leukapheresis and dose preparation procedures, per therapeutic dose, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: Q2042
Description: Tisagenlecleucel, up to 600 million CAR- positive viable T cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Source: New Hampshire Precertification List, Pg 253 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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