Q2058 prior authorization | Anthem Blue Cross and Blue Shield Virginia

Q2058, Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: Q2058
Description: Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 75 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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