CommercialBilling CodesMedium impact
08.02.23b, Tislelizumab-jsgr (Tevimbra®)
Independence Blue Cross·Oncology, Hematology, Pharmacy·Pharmacy
Effective date
Oct 1, 2026
We identified it
Oct 2, 2026
Summary
Independence Blue Cross updated policy 08.02.23b for Tislelizumab-jsgr (Tevimbra®) to add ICD-10 code C78.32 (Secondary malignant neoplasm of pharynx) effective October 1, 2026. This is a coding update that expands the diagnosis codes for which this immunotherapy drug is covered under the policy's existing medical necessity criteria.
Action Required
By September 15, 2026: Billing team must update billing system and claim submission software to recognize ICD-10 code C78.32 (Secondary malignant neoplasm of pharynx) as a covered diagnosis for HCPCS code J9329 (Tislelizumab-jsgr injection). Update internal policy reference materials and provider communication documents to reflect the expanded covered diagnoses. Ensure prior authorization workflows (if required by this plan) include the new diagnosis code. No claims should be submitted with C78.32 and J9329 before the effective date; claims submitted early will be denied. Coordinate with oncology providers to notify them of the expanded coverage.