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Medical Policy Updates and Effective Dates
CareFirst BlueCross BlueShield·Oncology, Hematology·Provider News
Effective date
Nov 15, 2025
We identified it
Jun 20, 2026
Summary
CareFirst will implement new coding edits for drugs and biologicals effective November 15, 2025. Claims with chemotherapy administration codes will be denied if no corresponding drug code is billed, and claims with invalid, expired, or mismatched NDC numbers will not be reimbursed.
Action Required
By November 15, 2025: Billing team must update claim review processes to ensure chemotherapy drug codes are billed alongside administration codes for the same date of service. Verify all NDC numbers are valid, current, and match corresponding HCPCS codes using NDC crosswalk before claim submission. Update billing software to flag these requirements. Claims will be denied without proper drug/administration code pairing or with invalid NDC information.