CommercialPrior AuthMedium impact
Inebilizumab-cdon (Uplizna™)
BCBS Tennessee·TN · Neurology, Rheumatology, Oncology·Medical Policy
Effective date
Jun 30, 2026
We identified it
Jun 17, 2026
Summary
BlueCross BlueShield of Tennessee is implementing a new medical policy for Inebilizumab-cdon (Uplizna™) requiring step therapy and prior authorization for three FDA-approved conditions: neuromyelitis optica spectrum disorder, immunoglobulin G4-related disease, and generalized myasthenia gravis. The policy includes specific coverage criteria and documentation requirements for each condition.
Action Required
Before June 30, 2026: Billing team must update prior authorization systems to require step therapy documentation and condition-specific clinical documentation for Inebilizumab-cdon (Uplizna™) claims. Providers must be trained on new documentation requirements including antibody test results, clinical classifications, and previous therapy trials. Update encounter forms to capture required clinical data for each of the three covered conditions.