CPT J7325 · HCPCS Drug · Wellpoint Maryland
Synvisc / Synvisc-One (HCPCS) at Wellpoint Maryland.
How Wellpoint Maryland approaches CPT J7325 (Synvisc / Synvisc-One (HCPCS)) for prior-authorization review: at last review on 2026-04-27, the policy covers this code with prior authorization required.
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CG-DRUG-15 / DRUG.00056Criteria summary
High-level themes from the Wellpoint Maryland policy of record for CPT J7325. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 12 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: Anthem Medical Policy CG-DRUG-15 / DRUG.00056 — Hyaluronic Acid Injections for Osteoarthritis
See the full Wellpoint Maryland criteria.
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