CommercialPrior AuthLow impact
Veopoz (pozelimab)
Blue Cross & Blue Shield of Mississippi·MS · Gastroenterology, Pediatrics, Internal Medicine·Medical Policy
Effective date
Mar 20, 2025
We identified it
Jun 20, 2026
Summary
BCBS Mississippi has established a new policy for Veopoz (pozelimab-bbfg), a specialty injection for rare CHAPLE disease, classifying it as not medically necessary since it hasn't been addressed in treatment guidelines. All services related to this medication require prior authorization approval through BCBSMS PA review process.
Action Required
By March 20, 2025: Billing team must flag HCPCS code J9376 (pozelimab-bbfg injection) as requiring prior authorization through BCBSMS PA review process before administration or billing. Update billing system to prevent claims submission without PA approval. Claims will be denied as not medically necessary without proper authorization.