CommercialPrior AuthHigh impact
Medical Policy and Coding Updates - April 2022
Premera Blue Cross·WA · Oncology, Rheumatology, Dermatology +4 more·Medical Policy
Effective date
Apr 1, 2022
We identified it
Jun 18, 2026
Summary
Premera Blue Cross updated multiple policies effective April 1, 2022, with additional changes through July 7, 2022. Key changes include new prior authorization requirements for various drugs and procedures, coverage changes for cancer treatments, and updates to autoimmune disease therapies including new atopic dermatitis treatments.
Action Required
Immediately: Update billing system to require prior authorization for codes J9273, J9359, J0219, J0879, J0491, C9093, Q5124, and genetic testing codes 0306U-0320U. Mark codes H2038, T2050, T2051 as non-covered. Update investigational review requirements for amniotic membrane codes Q4224, Q4225, Q4256, Q4257, Q4258 and bioengineered skin substitute codes A2011, A2012, A2013. Remove terminated codes C9084, C9085, C9086 from system. Notify providers of new atopic dermatitis drug coverage and reduced trial requirements for Dupixent.