J0717 prior authorization | Premera Blue Cross of Washington
J0717, Injection, certolizumab pegol, 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered), is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.
- Code
- J0717
- Description
- Injection, certolizumab pegol, 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
- Source
- Clinical Review by Code List PBCWA, Pg 699 Original policy