MedicaidPrior AuthMedium impact
Bizengri (zenocutuzumab-zbco) (New)
Humana·IN · Oncology, Pulmonology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has added a new prior authorization policy for Bizengri (zenocutuzumab-zbco), a cancer treatment for advanced non-small cell lung cancer and pancreatic adenocarcinoma with NRG1 gene fusion. This medication requires prior approval with specific criteria including documented gene fusion status and previous systemic therapy.
Action Required
Before January 1, 2026: Billing and clinical teams must implement prior authorization workflow for Bizengri (zenocutuzumab-zbco). Ensure providers document NRG1 gene fusion positive status, advanced/unresectable/metastatic disease stage, and previous systemic therapy in medical records. Visit www.humana.com/PAL for specific medical billing codes and submit prior auth requests before administering. Claims will be denied without prior authorization approval.