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Premera Blue CrossAll Plans · Billing Codes · Medical Policy · WA, AK · Oncology, Hematology, Cardiology +14 moreMedium impact

Medical Policy and Coding Updates - October 2019

Effective date
Not stated in the notice
Identified
Jun 18, 2026

Summary

This medical policy and coding update for WA and Alaska lists changes with effective dates from September 1, 2019 through January 3, 2020. Several medical policies state that a service may be considered medically necessary when criteria are met, while others are considered investigational, including irreversible electroporation (NanoKnife System) and implantable peripheral nerve stimulation for chronic pain. Coding updates effective October 1, 2019 add codes that now require review for medical necessity and prior authorization, including J1303, J9204, J0593, J9118 and Q5116.

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What to do

Action · 5 steps
01Already effective October 1, 2019: Get prior authorization for J1303, J9204, J0593, Q5116, Q5117, J9119, J9118, J9313, J0222, J3111, A9507 and Q5118, which the source says now require prior authorization.
02J7331 and J7332 now require review for medical necessity.
03Code 19105 now requires review for investigational status and no longer requires prior authorization.
04Code 54360 no longer requires prior authorization.
05Check current applicability before acting on these dates, and read the full policy at the source link for the other effective dates in this update.

Codes mentioned

J1303J9204J0593Q5116Q5117J7331J7332J9119J9118J9313J0222J3111A9507Q5118191055436081599

Original notice

Medical Policy and Coding Updates - October 2019
premera.com · Always check the source before changing claims.
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Related changes

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Medical Policy and Coding Updates - November 2025HighEffective Feb 6, 2026 · Medical PolicyMedical Policy and Coding Updates - December 2025HighNo effective date · Medical PolicyMedical Policy and Coding Updates - January 2026HighNo effective date · Medical PolicyMedical Policy and Coding Updates - February 2026HighNo effective date · Medical PolicyBrowse every Premera Blue Cross change in the policy list

Related policy hubs

Premera Blue Cross policiesWA policy changesAK policy changesOncologyHematologyCardiologyOrthopedicsPain ManagementENT (Ear, Nose & Throat)OphthalmologyRadiologyNeurologyOB-GYNUrologyPharmacyPulmonologyWound CareDermatologyPediatricsRheumatologyCode J1303Code J9204Code J0593Code Q5116Code Q5117Code J7331Code J7332Code J9119Code J9118Code J9313Code J0222Code J3111Code A9507Code Q5118Code 19105Code 54360Code 81599

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