J1412 prior authorization | Anthem Blue Cross and Blue Shield Virginia

J1412, Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: J1412
Description: Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 67 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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