Depakote ER 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 08, 2026

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield · Updated May 08, 2026

Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc. · Updated May 08, 2026

California - Uniform Prior Authorization FormCalifornia · Updated May 16, 2026

CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc. · Updated May 08, 2026

Cigna - General Medication Prior Authorization FormCigna Corporation · Updated May 08, 2026

Colorado - Uniform Prior Authorization FormColorado · Updated May 16, 2026

ICD-10 codes for Depakote ER Prior Authorizations

F30.10Manic episode without psychotic symptoms, mild or moderate severity

F30.13Manic episode without psychotic symptoms, severe

G40.209Localization-related (focal) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus

G40.211Localization-related (focal) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus

G40.301Generalized idiopathic epilepsy and epileptic syndromes characterized by absence seizures, not intractable, with status epilepticus

G40.309Generalized idiopathic epilepsy and epileptic syndromes characterized by absence seizures, not intractable, without status epilepticus

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