Pregabalin 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 Pregabalin Prior Authorizations

E11.40Type 2 diabetes mellitus with diabetic neuropathy, unspecified
E11.42Type 2 diabetes mellitus with diabetic polyneuropathy
E10.40Type 1 diabetes mellitus with diabetic neuropathy, unspecified
E10.42Type 1 diabetes mellitus with diabetic polyneuropathy
B02.29Postherpetic neuralgia, unspecified
G53.0Postzoster neuralgia
G40.109Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus
G40.209Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus
G40.009Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, without status epilepticus
M79.7Fibromyalgia
G89.4Chronic pain syndrome
G54.9Nerve root and plexus disorder, unspecified

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