Rayos 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 Rayos Prior Authorizations

L20.9Atopic dermatitis, unspecified
J30.9Allergic rhinitis, unspecified
T80.62XASerum reaction due to administration of blood and blood products, initial encounter
L13.0Dermatitis herpetiformis
L25.9Unspecified contact dermatitis
L26Exfoliative dermatitis
C84.90Mycosis fungoides, unspecified with respect to association with large cell transformation
L10.9Pemphigus, unspecified
L51.1Stevens-Johnson syndrome
E25.9Adrenogenital disorder, unspecified
E83.52Hypercalcemia
E27.9Adrenocortical insufficiency, unspecified
K50.90Crohn's disease of unspecified site without complications
K51.90Ulcerative colitis, unspecified, without complications
D59.1Other autoimmune hemolytic anemias
D61.01Constitutional aplastic anemia
D69.3Immune thrombocytopenia
D60.9Chronic acquired pure red cell aplasia
C85.90Lymphoma, unspecified, unspecified site
G35Multiple sclerosis
G93.6Cerebral edema
H44.011Unspecified endophthalmitis and uveitis, right eye
H20.9Uveitis, unspecified
J44.9Chronic obstructive pulmonary disease, unspecified
B90.81Allergic bronchopulmonary aspergillosis
J69.0Pneumonitis due to inhalation of food and vomit
J45.901Unspecified asthma with (acute) exacerbation
A15.0Tuberculosis of lung
J67.9Hypersensitivity pneumonitis, unspecified
J84.89Other specified alveolar and parietoalveolar conditions
J84.10Pulmonary fibrosis, unspecified
B59Pneumocystis infection
D86.9Sarcoidosis, unspecified
M45.9Ankylosing spondylitis of unspecified sites in spine
L40.50Arthropathic psoriasis, unspecified
M06.9Rheumatoid arthritis, unspecified
M32.9Systemic lupus erythematosus, unspecified
I80.9Phlebitis and thrombophlebitis of unspecified site
B75Trichinellosis
A17.0Tuberculous meningitis

Support for Getting Your Patient on Rayos

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.