Skyrizi (risankizumab) IV prior authorization for Crohn's disease and ulcerative colitis
This form governs prior authorization requests for intravenous Skyrizi (risankizumab) for inflammatory bowel disease (Crohn's disease and ulcerative colitis) and related infusion logistics for Cigna members; it affects ordering prescribers, infusion sites, specialty pharmacies, and Cigna utilization review staff.
No material clinical or coverage changes in this revision.
Coverage Criteria for Skyrizi (risankizumab) IV
Per the form, some Cigna plans require that infusion "MUST occur in the least intensive, medically appropriate setting." The prior authorization form collects the proposed site of administration (home, physician's office, hospital outpatient, or other) and asks whether the patient is a candidate for redirection to an alternate, less intensive setting with assistance from a Specialty Care Options Case Manager.
If the infusion is delivered in a more intensive site when a less intensive, medically appropriate setting is available and redirection is possible, coverage for that site of service may be denied per plan rules. The form therefore requires documentation confirming whether the patient is a candidate for redirection to an alternate setting (Yes/No) and requests a medical necessity rationale when redirection is not appropriate.
Billing and Diagnosis Codes
| J-code unspecified | Field provided for applicable J-Code for Skyrizi IV (not prefilled) |
| ICD10 unspecified | Field provided for ICD-10 diagnosis code |
Provider Actions and Submission Requirements
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.