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Independence Blue CrossCommercial · Billing Codes · Pharmacy · Oncology, PharmacyLow impact

08.02.42b, Penpulimab-kcqx

Act
by Sep 30, 2026
Effective date
Oct 1, 2026
Identified
Oct 2, 2026

Summary

Independence Blue Cross updated policy 08.02.42b for Penpulimab-kcqx effective 10/01/2026, adding ICD-10 code C78.32 (secondary malignant neoplasm of pharynx) to the covered diagnosis codes. This is a coding update that expands the policy's diagnostic scope for this immunotherapy drug used in various cancer treatments.

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What to do

by Sep 30, 2026 · 4 steps
01Billing and authorization teams must update internal policy documentation and claims processing system to recognize ICD-10 code C78.32 (secondary malignant neoplasm of pharynx) as a covered diagnosis code for Penpulimab-kcqx (HCPCS C9399, J3590).
02Update authorization templates and billing software to allow claims with this diagnosis code to proceed without denial.
03Inform oncology providers that secondary pharyngeal malignancies are now covered under this policy starting 10/01/2026.
04Test claims processing to ensure proper adjudication for this newly added diagnosis code.

Codes mentioned

C78.32C9399J3590C11.0C11.1C11.2C11.3C11.8C11.9C14.0C14.2C17.0C17.1C17.2C17.3C18.1C21.0C21.1C21.2C21.8C31.0C31.1

Original notice

08.02.42b, Penpulimab-kcqx
medpolicy.ibx.com · Always check the source before changing claims.
View original ↗

Related changes

See all Independence Blue Cross changes →
MA08.186a, Penpulimab-kcqxMediumEffective Jun 1, 2026 · PharmacyMA08.186, Penpulimab-kcqxMediumEffective Dec 29, 2025 · Pharmacy08.02.42, Penpulimab-kcqxMediumEffective Dec 29, 2025 · Pharmacy08.02.42a, Penpulimab-kcqxMediumEffective Jun 1, 2026 · PharmacyBrowse every Independence Blue Cross change in the policy list

Related policy hubs

Independence Blue Cross policiesOncologyPharmacyCode C78.32Code C9399Code J3590Code C11.0Code C11.1Code C11.2Code C11.3Code C11.8Code C11.9Code C14.0Code C14.2Code C17.0Code C17.1Code C17.2Code C17.3Code C18.1Code C21.0Code C21.1Code C21.2Code C21.8Code C31.0Code C31.1

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