CommercialCoverageLow impact
State and School Employees' Health Insurance Plan - Uplizna (inebilizumab-cdon)
Blue Cross & Blue Shield of Mississippi·MS · Neurology, Rheumatology·Medical Policy
Effective date
Dec 2, 2025
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield of Mississippi updated their policy on Uplizna (inebilizumab-cdon) for State and School Employees' Health Insurance Plan. The drug is now considered not medically necessary for both neuromyelitis optica spectrum disorder (NMOSD) and the newly added indication of immunoglobulin G4-related disease (IgG4-RD), as other covered treatment options are available.
Action Required
Immediately: Billing team must update system to flag HCPCS code J1823 (Uplizna injection) as not medically necessary for State and School Employees' Health Insurance Plan members. Claims for this code will likely be denied as the medication is considered not medically necessary with alternative treatments available. Update encounter forms to alert providers.