Duloxetine - Duloxetine capsule, Delayed Release 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.

California - Uniform Prior Authorization FormCalifornia
Colorado - Uniform Prior Authorization FormColorado
Illinois - Uniform Prior Authorization FormIllinois
Indiana - Uniform Prior Authorization FormIndiana
Louisiana - Uniform Prior Authorization FormLouisiana
Minnesota - Uniform Prior Authorization FormMinnesota

ICD-10 codes for Duloxetine - Duloxetine capsule, Delayed Release Prior Authorizations

F32.9Major depressive disorder, single episode, unspecified
F33.9Major depressive disorder, recurrent, unspecified
F41.1Generalized anxiety disorder
E11.42Type 2 diabetes mellitus with diabetic polyneuropathy
G63Polyneuropathy in diseases classified elsewhere
M79.7Fibromyalgia
M79.609Pain in unspecified limb
M54.9Dorsalgia, unspecified
G89.29Other chronic pain

Support for Getting Your Patient on Duloxetine - Duloxetine capsule, Delayed Release

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.