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June 2015

HCPCS code added to Medical Drug Prior Authorization Program

The following Healthcare Common Procedure Coding System code was added to the list of specialty drugs that require prior authorization, effective April 1, 2015.

Drug name

HCPCS code

Cimzia®

J0717

Blue Cross Blue Shield of Michigan reserves the right to change this list at any time.

Note: The prior authorization requirement does not apply to Medicare, Medicare Advantage or Federal Employee Program® members.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2014 American Medical Association. All rights reserved.
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