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Medical Policy and Coding Updates - January 2018
Premera Blue Cross·WA · Oncology, Neurology, Gastroenterology +5 more·Medical Policy
Effective date
Jan 1, 2018
We identified it
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.
Action Required
By January 1, 2018: Billing 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). Update billing system to route sleep disorder services to AIM Specialty Health instead of internal review. Replace code 0340T with 32994 for pulmonary tumor cryoablation. Stop using Q9989 for ustekinumab and use J3358 instead.