Benlysta 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.

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield
Blue Cross Blue Shield of Alabama - Benlysta Prior Authorization with Quantity Limit Program SummaryBlue Cross Blue Shield of Alabama
Blue Cross Blue Shield of Massachusetts - Immune Modulating Drugs Prior Authorization PolicyBlue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of Michigan - Medical Drug and Step Therapy Prior Authorization List for Medicare Plus Blue and BCN AdvantageBlue Cross Blue Shield of Michigan
Blue Cross Blue Shield of Michigan - Benlysta Prior Authorization Form (Medical Benefit)Blue Cross Blue Shield of Michigan
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc.

ICD-10 codes for Benlysta Prior Authorizations

M32.9Systemic lupus erythematosus, unspecified
M32.19Other organ or system involvement in systemic lupus erythematosus
M32.14Glomerular disease in systemic lupus erythematosus

Brand Resources

Coverage & Formulary Information For BenlystaFormulary information
Billing & Coding GuideResource for billing and coding
Pharmacy ListPharmacy List resource
How to Order BenlystaHow to Order Benlysta resource
Reimbursment InformationReimbursment Information resource

Support for Getting Your Patient on Benlysta