Human growth hormone

No prior authorization required for:

  • Emergency room
  • Inpatient
  • Skilled nursing facility

Injectable auth/billing notes:

Medications billed with miscellaneous codes will be reviewed. Explanatory notes must accompany the claim.

Priority Health Medicare applies CMS local coverage determination criteria when available for Part B drugs.

Code(s):  J9465, J7320-J7328 

Benefit: Pharmacy

Notes: Per 1 mg; human growth hormone (HGH).

Preferred:

NORDITROPIN®

Other:

GENOTROPIN®
HUMATROPE®
NUTROPIN AQ®
OMNITROPE®
PROTROPIN®
SAIZEN®
ZORBTIVE™
ZOMACTON®