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.

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc.
California - Uniform Prior Authorization FormCalifornia
CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc.
Cigna - General Medication Prior Authorization FormCigna Corporation
Colorado - Uniform Prior Authorization FormColorado

ICD-10 codes for Welireg Prior Authorizations

Q85.83Von Hippel-Lindau syndrome
C64.9Malignant neoplasm of unspecified kidney, except renal pelvis
C64.1Malignant neoplasm of right kidney, except renal pelvis
C64.2Malignant neoplasm of left kidney, except renal pelvis
D33.0Benign neoplasm of brain, supratentorial
D33.1Benign neoplasm of brain, infratentorial
D33.4Benign neoplasm of spinal cord
C25.4Malignant neoplasm of endocrine pancreas
D35.00Benign neoplasm of unspecified adrenal gland
D35.01Benign neoplasm of right adrenal gland
C74.10Malignant neoplasm of medulla of unspecified adrenal gland
C74.11Malignant neoplasm of medulla of right 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

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.