Darzalex Faspro 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

Accredo - Specialty Pharmacy Referral FormAccredo · 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 Tennessee - Federal Employee Program and Postal Predetermination Prior Approval Request FormBlue Cross Blue Shield of Tennessee · 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 Darzalex Faspro Prior Authorizations

C90.00Multiple myeloma not having achieved remission
C90.01Multiple myeloma in remission
E85.8Other amyloidosis
E85.9Amyloidosis, unspecified

Appeal Templates

If the payer denies coverage, these templates help you build a stronger appeal.
Letter of Medical Necessity Letter of Medical Necessity resource
A peer-to-peer review with the payer's medical director can often resolve denials faster than a formal appeal.

Brand Resources

How To Order Darzalex FasproHow To Order Darzalex Faspro resource
Reimbursement & Access Guide Reimbursement & Access Guide resource
Letter of ExceptionLetter of Exception resource

Support for Getting Your Patient on Darzalex Faspro

Check coverage & formulary statusVerify PA requirements for your patient's plan.Find savings programsCopay cards, patient assistance, and more.Check medication interactionsScreen prescriptions for harmful drug combinations.