Our Preauthorization List has been updated to include Pluvicto™ (lutetium Lu 177 vipivotide tetraxetan); a new FDA approved radiopharmaceutical used for treatment of progressive, prostate-specific membrane antigen (PSMA) positive, metastatic castration-resistant prostate cancer.
New Codes Requiring Preauthorization Starting August 1, 2022
| CPT/HCPCS Code | CPT/HCPCS Code Description |
|---|---|
| A9699 | (Radiopharmaceutical, therapeutic, not otherwise classified) Temporary Code through 9/30/2022 (see A9607 effect 10/01/2022) |
| A9607 | Pluvicto™ (Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie) Replacement Code for A9699 - effective 10/01/2022 |
