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Medical Criteria Update April 6, 2022
| Medical Criteria | Reason for Update |
|---|---|
| Place of Service (PDF) | Added the following drugs and HCPCS codes for clarity, with criteria also available in individual policies: Nexviazyme (C9085, J3490, J3590), Saphnelo (C9086, J3490, J3590), Tezspire (C9399, J3490, J3590), Enjaymo (C9399** J3490**, J3590**), and Leqvio (C9399, J3490, J3590). Updated HCPCS code for Evkeeza to J1305. |
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