Casgevy 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

AmeriHealth Caritas Pennsylvania - Prior Authorization FormAmeriHealth Caritas Pennsylvania · Updated May 10, 2026

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield · Updated May 11, 2026

Blue Cross Blue Shield of Massachusetts - Prior Authorization Request Form for Gene Therapies for Sickle Cell DiseaseBlue Cross Blue Shield of Massachusetts · Updated May 10, 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 Apr 16, 2026

CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc. · Updated May 11, 2026

ICD-10 codes for Casgevy Prior Authorizations

D57.00Hb-SS disease with crisis, unspecified

D56.1Beta thalassemia

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