Q2055 prior authorization | Anthem Blue Cross Blue Shield of Georgia

Q2055, Idecabtagene vicleucel, up to 460 million autologous B-cell maturation antigen (BCMA) directed CAR-positive 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: Q2055
Description: Idecabtagene vicleucel, up to 460 million autologous B-cell maturation antigen (BCMA) directed CAR-positive 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

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