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Premera Blue CrossCommercial · Prior Auth · Medical Policy · WA, AK · Oncology, Hematology, Rheumatology +4 moreHigh impact

Medical Policy and Coding Updates - September 2020

Act
by Dec 3, 2020
Effective date
Sep 1, 2020
Identified
Jun 18, 2026

Summary

Multiple oncology and specialty drugs have been added to covered policies with new prior authorization requirements, effective across three dates in September-December 2020. New billing codes have been added requiring prior auth review, while some amniotic membrane injection codes no longer require authorization.

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What to do

by Dec 3, 2020 · 4 steps
01Billing team must update system to require prior authorization for new drug codes J2507, J9305, and J9307.
02Update encounter forms to reflect that codes 65778 and 65779 (amniotic membrane injections) no longer require prior auth.
03Configure investigational review alerts for code 0062U.
04Train staff that tandem autologous hematopoietic cell transplantation for Hodgkin lymphoma is now investigational and will require special handling.

Codes mentioned

J2507J9305J93076577865779

Original notice

Medical Policy and Coding Updates - September 2020
premera.com · Always check the source before changing claims.
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Related changes

See all Premera Blue Cross changes →
Medical Policy and Coding Updates - May 2019HighEffective May 1, 2019 · Medical PolicyMedical Policy and Coding Updates - November 2026HighEffective Nov 1, 2026 · Medical PolicyMedical Policy and Coding Updates - November 2026HighNo effective date · Medical PolicyMedical Policy and Coding Updates - October 2026HighNo effective date · Medical PolicyBrowse every Premera Blue Cross change in the policy list

Related policy hubs

Premera Blue Cross policiesWA policy changesAK policy changesOncologyHematologyRheumatologyGastroenterologyOphthalmologyUrologyOB-GYNCode J2507Code J9305Code J9307Code 65778Code 65779

Summaries are AI-assisted. Always confirm against the original payer notice.

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