5 commercial payer policies list J3260. 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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5 policies from 4 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 J3260 |
|---|---|---|
| Tobramycin inhaled products (Tobi, Tobi Podhaler, Bethkis, Kitabis Pak)Effective 01/01/2019 - 11/30/2019 | Jan 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Tobramycin inhaled products (Tobi, Tobi Podhaler, Bethkis, Kitabis Pak)Effective 12/01/2019 - 09/30/2020 | Dec 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J3260 |
|---|---|---|
| Tobramycin (Bethkis, Kitabis Pak, TOBI, TOBI Podhaler); CP.PHAR.211 | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J3260 |
|---|---|---|
| 00519 Inhaled Antibiotics for Cystic Fibrosis (tobramycin, Tobi, Tobi Podhaler, Bethkis, Cayston) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J3260 |
|---|---|---|
| Tobi Podhaler (tobramycin) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |