Q2053 prior authorization | Anthem Blue Cross Blue Shield of Georgia
Q2053, Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose, is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.
- Code
- Q2053
- Description
- Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
- Source
- Standard Local Prior Authorization Code List, Pg 118 Original policy
Anthem Blue Cross Blue Shield of Georgia prior authorization