Imlygic® (talimogene)
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): J9325
Benefit: Medical
Notes: Intralesional, intranodal or subcutaneous treatment of cutaneous lesion -0 multiple melanoma