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C9399 prior authorization | Anthem Blue Cross Blue Shield of California

C9399, Unclassified drugs or biologicals [when specified as lifileucel (Amtagvi)] or [when specified as eladocagene exuparvovec- tneq (Kebilidi)] or [when specified as an ocular gene therapy agent other than voretigene neparvovec-rzyl (Luxturna)] or [when specified as etuvetidigene autotemcel (Waskyra)] or [when specified as a gene therapy for hemophilia other than Hemgenix, Beqvez, or Roctavian] or [when describing a product with no specific code indicated as investigational and not medically necessary], is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code
C9399
Description
Unclassified drugs or biologicals [when specified as lifileucel (Amtagvi)] or [when specified as eladocagene exuparvovec- tneq (Kebilidi)] or [when specified as an ocular gene therapy agent other than voretigene neparvovec-rzyl (Luxturna)] or [when specified as etuvetidigene autotemcel (Waskyra)] or [when specified as a gene therapy for hemophilia other than Hemgenix, Beqvez, or Roctavian] or [when describing a product with no specific code indicated as investigational and not medically necessary]
Source
California PPO Prior Authorization List, Pg 22 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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