2 commercial payer policies list J1645. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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2 policies from 2 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
Codes labeled “Inferred from policy title” are not listed in the policy document; Backwork attached them because the policy title names the drug.
| Policy | Effective | Status of J1645 |
|---|---|---|
| Recurrent Pregnancy Loss | Feb 15, 2024 | Covered |
| Policy | Effective | Status of J1645 |
|---|---|---|
| Dalteparin (Fragmin); CP.PHAR.225 | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |