Depakote 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: Apr 24, 2026

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield · Updated Apr 24, 2026
Blue Cross Blue Shield of Tennessee - Predetermination 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 Apr 24, 2026
California - Uniform Prior Authorization FormCalifornia · Updated Apr 16, 2026
CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc. · Updated Apr 24, 2026
CareSource - Prior Authorization Provider FormCareSource Management Group · Updated May 10, 2026

ICD-10 codes for Depakote Prior Authorizations

F31.9Bipolar disorder, unspecified
F31.10Bipolar disorder, current episode manic without psychotic features, unspecified
F31.13Bipolar disorder, current episode manic without psychotic features, severe
F31.2Bipolar disorder, current episode manic severe with psychotic features
G40.209Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus
G40.219Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus
G40.A09Absence epileptic syndrome, not intractable, without status epilepticus
G40.A19Absence epileptic syndrome, intractable, without status epilepticus
G43.909Migraine, unspecified, not intractable, without status migrainosus
G43.919Migraine, unspecified, intractable, without status migrainosus

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