CommercialCoverageMedium impact
08.01.47a, Triamcinolone Acetonide Extended-Release Injectable (Zilretta®)
Independence Blue Cross·Orthopedics, Pain Management, Pharmacy·Pharmacy
Effective date
Apr 30, 2025
We identified it
Jun 19, 2026
Summary
Policy 08.01.47a regarding Triamcinolone Acetonide Extended-Release Injectable (Zilretta®) has been reissued effective April 30, 2025. This is a recent pharmacy policy change that may affect coverage, prior authorization requirements, or billing procedures for this injectable corticosteroid medication. The specific policy details are not fully available in the provided information, requiring the billing team to access the full policy document to identify exact coverage and billing requirements.
Action Required
By April 30, 2025: Billing team must access and review the complete policy document at https://medpolicy.ibx.com/ibc/Commercial/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=04&FilterField2=MPSiteActivityLogYear&FilterValue2=2025#commercial-08-01-47a to identify specific HCPCS codes (likely J-codes for Zilretta®), prior authorization requirements, and coverage limitations. Update billing software, prior auth workflows, and provider communication materials accordingly. Ensure all claims submitted on or after April 30, 2025 comply with the reissued policy requirements. Communicate changes to providers who administer or bill for Zilretta® injections to prevent claim denials.