Coding That Helps Get Elaprase (Idursulfase) Approved in Virginia with UnitedHealthcare: ICD-10, HCPCS/J-Code, and NDC Guide
Answer Box: Getting Elaprase Covered by UnitedHealthcare in Virginia
Fast track to approval: Use ICD-10 code E76.1 (Hunter syndrome), HCPCS J1743 for billing, and NDC 54092-0700-01. Submit prior authorization through UnitedHealthcare Provider Portal with enzymatic/genetic test results confirming Hunter syndrome diagnosis. If denied, file Virginia external review using