Lyrica Prior Authorization Resources

Find the right PA form for your patient's payer, get the ICD-10 codes you need, and download appeal templates — all in one place.

Last verified: May 11, 2026

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield · Updated May 11, 2026

Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc. · Updated May 11, 2026

California - Uniform Prior Authorization FormCalifornia · Updated May 16, 2026

CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc. · Updated May 11, 2026

Cigna - General Medication Prior Authorization FormCigna Corporation · Updated May 11, 2026

Colorado - Uniform Prior Authorization FormColorado · Updated May 16, 2026

ICD-10 codes for Lyrica Prior Authorizations

E11.40Type 2 diabetes mellitus with diabetic neuropathy with the stated type not specified

E10.40Type 1 diabetes mellitus with diabetic neuropathy with the stated type not specified

G63.2Diabetic polyneuropathy

G40.109Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, without status epilepticus

M79.7Fibromyalgia

G89.29Other chronic pain

G89.21Chronic pain due to trauma

Support for Getting Your Patient on Lyrica

Check coverage & formulary statusVerify PA requirements for your patient's plan.Find savings programsCopay cards, patient assistance, and more.Check medication interactionsScreen prescriptions for harmful drug combinations.