CommercialBilling CodesMedium impact
Pharmacy Policies Updates
Blue Cross Blue Shield of North Dakota·ND·Pharmacy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
BCBS North Dakota updated multiple pharmacy utilization management programs and added new medical drug billing codes. Key changes include additions of new drugs to various prior authorization programs and new HCPCS codes C9309 and J1569 for specific medications effective April 1, 2026.
Action Required
By April 1, 2026: Billing team must update system to include new HCPCS codes C9309 (Itvisma) and J1569 (Gammagard Liquid ERC IV and SQ). Update drug formulary references for prior authorization requirements effective June 1, 2026. Monitor www.myprime.com/en/forms.html for updated clinical criteria forms after June 1, 2026.