Medical Policy and Coding Updates - January 2025
Premera's January 2025 update adds Carelon imaging, genetic testing and radiation oncology guideline changes for dates of service on and after April 20, 2025, and adds new Insulin Therapy and SGLT2 Inhibitors pharmacy policies effective January 1, 2025. It also adds Kisunla to the amyloid antibody policy and lists coding updates that now require review for medical necessity and prior authorization, including amyloid antibody code J0175, folate antimetabolite code J9292, and sickle cell disease code J3392.