Q2043 prior authorization | Blue Cross and Blue Shield of Montana

Q2043, Sipuleucel-T Minimum Of 50 Carelon Million Autologous Cd54+ Cells Activated With Pap-Gm- Csf Including Leukapheresis And All Other Preparatory Procedures Per Infusion, is on the Blue Cross and Blue Shield of Montana prior authorization list. Not a coverage or referral decision.

Code: Q2043
Description: Sipuleucel-T Minimum Of 50 Carelon Million Autologous Cd54+ Cells Activated With Pap-Gm- Csf Including Leukapheresis And All Other Preparatory Procedures Per Infusion
Source: 2026 Specialty Drugs and Infusion Site of Care Prior Authorization Code List, Pg 24 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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