Who is affected by this change?

This affects Blue Cross Blue Shield of North Dakota Oncology, Hematology, Endocrinology providers in ND on Commercial plans.

When does this change take effect?

This change is effective Jan 13, 2026.

Pharmacy Policies Updates

Q: Which billing codes are affected?

The following codes are affected: C9301, J9999, Q2058, J3590, C91.01, C65.1, C65.2, C65.9, C83.30, C83.31, C83.32, C83.33, C83.34, C83.35, C83.36, C83.37, C83.38, C83.39, C83.70, C83.71, C83.72, C83.73, C83.74, C83.75, C83.76, C83.77, C83.78, C83.79, C85.20, C85.21, C85.22, C85.23, C85.24, C85.25, C85.26, C85.27, C85.28, C85.29, D47.Z1, E78.01, E78.010.

Summary

Blue Cross Blue Shield of North Dakota updated prior authorization policies for multiple specialty pharmaceutical drugs effective January 13, 2026. Changes include authorization duration modifications, dosing limit updates, expanded indications for several cancer treatments, and addition of new biosimilar products.

Action Required

Action needed

By January 13, 2026: Billing teams must update prior authorization systems to reflect new authorization durations for specialty cancer drugs including Abecma, Adcetris, Breyanzi, and Carvykti. Update billing codes - discontinue using C9301 and J9999 (discontinued 07/01/2025), use Q2058 for Aucatzyl instead. Remove HCPCS J3590 for specific denosumab products discontinued 10/01/2025. Add new biosimilar products for aflibercept, denosumab, and IVIG to formulary systems. Update ICD-10 coding to include new pediatric lymphoma codes and remove outdated codes.

Affected Billing Codes

C9301

J9999

Q2058

J3590

C91.01

C65.1

C65.2

C65.9

C83.30

C83.31

C83.32

C83.33

C83.34

C83.35

C83.36

C83.37

C83.38

C83.39

C83.70

C83.71

C83.72

C83.73

C83.74

C83.75

C83.76

C83.77

C83.78

C83.79

C85.20

C85.21

C85.22

C85.23

C85.24

C85.25

C85.26

C85.27

C85.28

C85.29

D47.Z1

E78.01

E78.010

Related policy hubs

Blue Cross Blue Shield of North Dakota policies ND policy changes Oncology Hematology Endocrinology Code C9301 Code J9999 Code Q2058 Code J3590 Code C91.01 Code C65.1 Code C65.2 Code C65.9 Code C83.30 Code C83.31 Code C83.32 Code C83.33 Code C83.34 Code C83.35 Code C83.36 Code C83.37 Code C83.38 Code C83.39 Code C83.70 Code C83.71 Code C83.72 Code C83.73 Code C83.74 Code C83.75 Code C83.76 Code C83.77 Code C83.78 Code C83.79 Code C85.20 Code C85.21 Code C85.22 Code C85.23 Code C85.24 Code C85.25 Code C85.26 Code C85.27 Code C85.28 Code C85.29 Code D47.Z1 Code E78.01 Code E78.010