Medicare AdvantageDocumentationLow impact
MA08.152d, Nivolumab and relatlimab-rmbw (Opdualag™) for intravenous use
Independence Blue Cross·Oncology, Dermatology·Pharmacy
Effective date
Jun 16, 2025
We identified it
Jun 19, 2026
Summary
This is a reissue of Independence Blue Cross Medicare Advantage policy MA08.152d with no substantive coverage changes. The policy was updated to align with NCCN Melanoma guidelines (V2.2025) and all ICD-10 diagnosis codes were removed as informational. Opdualag (nivolumab and relatlimab-rmbw) coverage criteria remain unchanged for unresectable/metastatic melanoma and resectable melanoma neoadjuvant therapy. The effective date is 06/16/2025.
Action Required
By June 16, 2025: Billing team should note that ICD-10 diagnosis codes have been removed from this policy document. Providers must continue to report the most appropriate diagnosis code in support of medically necessary criteria as listed in the policy on all claims for HCPCS code J9298 (nivolumab and relatlimab-rmbw). No changes to prior authorization processes or coverage criteria are required, as this is a reissue with no substantive changes. Update internal policy files to the 03/04/2026 revision date for reference.