Medicare AdvantageCoverageMedium impact
MA08.183, Zenocutuzumab-zbco (Bizengri®)
Independence Blue Cross·Oncology, Pharmacy·Pharmacy
Effective date
Jul 28, 2025
We identified it
Jun 19, 2026
Summary
MA08.183 is a new Medicare Advantage policy establishing coverage criteria for Zenocutuzumab-zbco (Bizengri®), a new pharmaceutical agent. The billing team must implement this policy immediately to ensure claims for this drug are processed according to new coverage guidelines, prior authorization requirements, and any applicable billing codes.
Action Required
By July 28, 2025: Billing team must obtain and review the full MA08.183 policy document at https://medpolicy.ibx.com/ibc/ma/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=07&FilterField2=MPSiteActivityLogYear&FilterValue2=2025 to identify specific HCPCS drug codes, prior authorization requirements, medical necessity criteria, and documentation requirements for Zenocutuzumab-zbco (Bizengri®). Update billing system templates and prior authorization workflows accordingly. Notify prescribing providers of any new documentation or clinical criteria requirements. Ensure all claims for this drug include required prior authorization before submission to avoid denials.