CommercialCoverageMedium impact
08.01.71, Collagenase clostridium histolyticum (Xiaflex ®), collagenase clostridium histolyticum-aaes (Qwo®)
Independence Blue Cross·Dermatology, Plastic Surgery·Pharmacy
Effective date
May 28, 2025
We identified it
Jun 19, 2026
Summary
Policy 08.01.71 was reissued on 05/28/2025 regarding coverage and billing for Xiaflex® (collagenase clostridium histolyticum) and Qwo® (collagenase clostridium histolyticum-aaes). The billing team must review the full policy text to identify specific coverage criteria, prior authorization requirements, and billing code updates that may affect claims processing for these medications.
Action Required
By 06/28/2025: Billing team must obtain and review the complete full policy text from the source URL (https://medpolicy.ibx.com/ibc/Commercial/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=05&FilterField2=MPSiteActivityLogYear&FilterValue2=2025#commercial-08-01-71) to identify specific HCPCS codes, prior authorization requirements, medical necessity criteria, and coverage limitations for Xiaflex® and Qwo®. Update billing software, encounter forms, and prior authorization workflows accordingly. Ensure all claims submitted on or after 05/28/2025 comply with reissued policy terms. Without review and implementation, claims may be denied or delayed.