Linezolid (generic Zyvox®)

Authorization forms

Medicare (01/2019)

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): J2020

Benefit: Medical

Notes: 2mg/mL in 100, 200, and 300ml single use bags

Criteria for coverage:
•     See PA form for criteria for Commercial, Medicaid