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Arkansas Blue Cross Blue ShieldCommercial · Coverage · Medical Policy · AR · Oncology, HematologyMedium impact

Policy Criteria Changes

Act
by Mar 31, 2025
Effective date
Dec 15, 2025
Identified
Jun 19, 2026

Summary

Arkansas Blue Cross updated coverage criteria for Tislelizumab-jsgr (Tevimbra) to include FDA-labeled gastric cancer indication and revised off-label uses. Belantamab mafodotin-blmf (Blenrep) policy will be archived as HCPCS code J9037 becomes inactive March 31, 2025.

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What to do

by Mar 31, 2025 · 2 steps
01Billing team must stop using HCPCS code J9037 for Belantamab mafodotin-blmf (Blenrep) as it becomes inactive.
02Update billing software to remove this code and ensure proper prior authorization for Tislelizumab-jsgr when used for gastric cancer treatment per new FDA-labeled criteria.

Codes mentioned

J9037

Original notice

Policy Criteria Changes
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