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Premera Blue CrossAll Plans · Prior Auth · Medical Policy · WA · Oncology, Neurology, Gastroenterology +5 moreHigh impact

Medical Policy and Coding Updates - January 2018

Act
by Jan 1, 2018
Effective date
Jan 1, 2018
Identified
Jun 18, 2026

Summary

Multiple policy updates effective January 1, 2018, including new prior authorization requirements for numerous specialty drugs and procedures, coverage changes for CAR T-cell therapies and various medical devices, and transfer of sleep disorder services to AIM Specialty Health for review.

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What to do

by Jan 1, 2018 · 4 steps
01Billing team must update prior authorization requirements for all listed codes including CAR T-cell therapies (Q2040), specialty drugs (J1428, J1555, J9022, J9023, J9285, J3358, J2350, J2326), amniotic membrane products (Q4176-Q4181), and bioengineered skin substitutes (Q4179, Q4182).
02Update billing system to route sleep disorder services to AIM Specialty Health instead of internal review.
03Replace code 0340T with 32994 for pulmonary tumor cryoablation.
04Stop using Q9989 for ustekinumab and use J3358 instead.

Codes mentioned

Q4176Q4177Q4178Q4180Q4181Q4179Q4182Q2040J1428J1555J9022J9023J9285J3358J2350J232627412J7330S2112S210732994Q9989

Original notice

Medical Policy and Coding Updates - January 2018
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 - May 2019HighEffective May 1, 2019 · Medical PolicyMedical Policy and Coding Updates - June 2018MediumNo effective date · Medical PolicyMedical Policy and Coding Updates - February 2025HighNo effective date · Medical PolicyBrowse every Premera Blue Cross change in the policy list

Related policy hubs

Premera Blue Cross policiesWA policy changesOncologyNeurologyGastroenterologyWound CareOrthopedicsPulmonologySleep MedicineDermatologyCode Q4176Code Q4177Code Q4178Code Q4180Code Q4181Code Q4179Code Q4182Code Q2040Code J1428Code J1555Code J9022Code J9023Code J9285Code J3358Code J2350Code J2326Code 27412Code J7330Code S2112Code S2107Code 32994Code Q9989

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