Welireg 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 May 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 May 16, 2026

ICD-10 codes for Welireg Prior Authorizations

Q85.8Other phakomatoses, not elsewhere classified
C64.1Malignant neoplasm of right kidney, except renal pelvis
C64.2Malignant neoplasm of left kidney, except renal pelvis
C64.9Malignant neoplasm of unspecified kidney, except renal pelvis
C74.10Malignant neoplasm of medulla of unspecified adrenal gland
D35.00Benign neoplasm of unspecified adrenal gland
C75.5Malignant neoplasm of aortic body and other paraganglia
D44.7Neoplasm of uncertain behavior of aortic body and other paraganglia
D35.6Benign neoplasm of aortic body and other paraganglia

Appeal Templates

If the payer denies coverage, these templates help you build a stronger appeal.
Coverage Authorization Appeals Coverage Authorization Appeals resource
Appeals Checklist Appeals Checklist resource
A peer-to-peer review with the payer's medical director can often resolve denials faster than a formal appeal.

Brand Resources

Coverage Authorization Request Coverage Authorization Request resource
PA Checklist PA Checklist resource
Pharmacy List: von Hippel-Lindau (VHL) DiseasePharmacy List: von Hippel-Lindau (VHL) Disease resource
Pharmacy List: Renal Cell CarcinomaPharmacy List: Renal Cell Carcinoma resource

Support for Getting Your Patient on Welireg

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