CommercialPrior AuthMedium impact
Zenocutuzumab-zbco (Bizengri®)
BCBS Tennessee·TN · Oncology, Pulmonology·Medical Policy
Effective date
Sep 30, 2026
We identified it
Jul 17, 2026
Summary
BlueCross BlueShield of Tennessee is implementing a new prior authorization policy for Zenocutuzumab-zbco (Bizengri®), a targeted cancer therapy for NRG1 gene fusion-positive advanced or metastatic NSCLC, pancreatic adenocarcinoma, and biliary tract cancers. Prior authorization requires documentation of NRG1 gene fusion status and disease progression on prior systemic therapy, with 12-month authorization periods granted for single-agent use. The policy becomes effective September 30, 2026, and must NOT be implemented before that date.
Action Required
Before September 30, 2026: Billing and clinical teams must establish prior authorization workflows for Zenocutuzumab-zbco (Bizengri®). Update billing system rules to flag all claims for this drug requiring prior auth submission. Ensure providers document NRG1 gene fusion status and evidence of disease progression on prior systemic therapy before requesting authorization. Create or update prior auth templates to capture required documentation. Notify oncology providers of the 12-month authorization periods and single-agent use requirement. DO NOT implement this policy before 9/30/26 per policy instructions. Claims submitted without prior authorization after the effective date will be denied.