CommercialPrior AuthHigh impact
Announcements
Blue Cross Blue Shield of Wyoming·WY · Oncology, Rheumatology, Nephrology +3 more·Prior Authorization
Effective date
Oct 1, 2024
We identified it
Jun 19, 2026
Summary
Effective 10/1/24, BCBS Wyoming no longer accepts prior authorizations using the generic J3490 code when a specific HCPCS code exists for the requested drug. Additionally, home infusion therapy billing for compounded sterile preparations must use code S9430 per dose, which includes all professional pharmacy services.
Action Required
Immediately: Billing team must stop using J3490 for prior authorizations when specific HCPCS codes exist - use the appropriate drug-specific HCPCS code instead or authorizations will be rejected. For home infusion therapy, bill S9430 per dose for compounded sterile preparations instead of separate pharmacy service codes. Update billing software rules and train staff on proper code selection.