Axumin Prior Authorization Resources

Find the right PA form for your patient's payer, get the ICD-10 codes you need, and download appeal templates — all in one place.

Last verified: May 11, 2026

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield · Updated May 11, 2026
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc. · Updated May 11, 2026
California - Uniform Prior Authorization FormCalifornia · Updated May 16, 2026
CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc. · Updated May 11, 2026
Cigna - General Medication Prior Authorization FormCigna Corporation · Updated May 11, 2026
Colorado - Uniform Prior Authorization FormColorado · Updated May 16, 2026

ICD-10 codes for Axumin Prior Authorizations

C61.9Malignant neoplasm of prostate, unspecified
C79.82Secondary malignant neoplasm of unspecified site of unspecified bone and bone marrow

Brand Resources

Reimbursement Information Reimbursement Information resource
Benefits Investigation SupportBenefits Investigation Support resource
Billing & Coding Guide Billing & Coding Guide resource
How to Order Axumin How to Order Axumin resource

Support for Getting Your Patient on Axumin

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