CommercialPrior AuthMedium impact
08.01.59f, Polatuzumab vedotin-piiq (Polivy®)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Dec 29, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross has updated the medical necessity criteria and medical coding requirements for Polatuzumab vedotin-piiq (Polivy®), an oncology medication. This affects billing and prior authorization requirements for this specific drug therapy.
Action Required
By December 29, 2025: Billing team must review updated medical necessity criteria for Polatuzumab vedotin-piiq (Polivy®) and update prior authorization processes accordingly. Oncology providers should ensure documentation meets new medical necessity requirements to avoid claim denials.