Erbitux 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.

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc.
California - Uniform Prior Authorization FormCalifornia
CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc.
Cigna - General Medication Prior Authorization FormCigna Corporation
Cigna - Erbitux Prior Authorization FormCigna Corporation

ICD-10 codes for Erbitux Prior Authorizations

C10Malignant neoplasm of oropharynx
C11Malignant neoplasm of nasopharynx
C13Malignant neoplasm of hypopharynx
C32Malignant neoplasm of larynx
C18.9Malignant neoplasm of colon, unspecified
C20Malignant neoplasm of rectum

Appeal Templates

If the payer denies coverage, these templates help you build a stronger appeal.
First-Level Appeal Letter for Commercial or Other InsuranceFirst-Level Appeal Letter for Commercial or Other Insurance resource
Second-Level Appeal Letter for Commercial or Other InsuranceSecond-Level Appeal Letter for Commercial or Other Insurance resource
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 ErbituxHow To Order Erbitux resource
Billing & Coding GuideBilling & Coding Guide resource
Denied Claims Checklist Denied Claims Checklist resource
First-Level Medicare Review LetterFirst-Level Medicare Review Letter resource
Second-Level Medicare Review LetterSecond-Level Medicare Review Letter resource

Support for Getting Your Patient on Erbitux