Lutathera 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 11, 2026

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield · Updated May 11, 2026
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc. · Updated May 11, 2026
California - Uniform Prior Authorization FormCalifornia · Updated Apr 16, 2026
CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc. · Updated May 11, 2026
Cigna - General Medication Prior Authorization FormCigna Corporation · Updated May 11, 2026
Colorado - Uniform Prior Authorization FormColorado · Updated Apr 16, 2026

ICD-10 codes for Lutathera Prior Authorizations

C7A.010Malignant carcinoid tumor of the duodenum
C7A.011Malignant carcinoid tumor of the jejunum
C7A.012Malignant carcinoid tumor of the ileum
C7A.020Malignant carcinoid tumor of the appendix
C7A.021Malignant carcinoid tumor of the cecum
C7A.022Malignant carcinoid tumor of the ascending colon
C7A.023Malignant carcinoid tumor of the transverse colon
C7A.024Malignant carcinoid tumor of the descending colon
C7A.025Malignant carcinoid tumor of the sigmoid colon

Brand Resources

How To Order LutatheraHow To Order Lutathera resource
Lutathera Reimbursement GuideLutathera Reimbursement Guide resource

Support for Getting Your Patient on Lutathera

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