Lupron Depot 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 - Gonadotropin-releasing Hormone (GnRH) Antagonists Prior Authorization Form Cigna Corporation

ICD-10 codes for Lupron Depot Prior Authorizations

N80.9Endometriosis, unspecified
N80.0Endometriosis of uterus
D25.9Leiomyoma of uterus, unspecified

Brand Resources

How To Order Lupron Depot: Advanced Prostate Cancer How To Order Lupron Depot: Advanced Prostate Cancer resource
Coding & Billing Information: Advanced Prostate CancerCoding & Billing Information: Advanced Prostate Cancer resource

Support for Getting Your Patient on Lupron Depot

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.