CommercialCoverageMedium impact
Uplizna (inebilizumab-cdon)
Blue Cross & Blue Shield of Mississippi·MS · Neurology, Rheumatology·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their policy for Uplizna (inebilizumab-cdon), expanding the 'not medically necessary' determination to include treatment of immunoglobulin G4-related disease (IgG4-RD) in addition to NMOSD. The policy also clarifies that administration services for medications not approved through prior authorization will be denied.
Action Required
Immediately: Update billing system to flag HCPCS code J1823 (inebilizumab-cdon injection) as 'not medically necessary' for both NMOSD and IgG4-RD treatment under BCBS Mississippi. Billing team must verify prior authorization approval through BCBSMS PA review process before billing any administration services. Claims without proper PA approval will be denied as not medically necessary.