CommercialPrior AuthHigh impact
Coding Update - J3490
Blue Cross Blue Shield of Wyoming·WY·Prior Authorization
Effective date
Oct 1, 2024
We identified it
Jun 19, 2026
Summary
Effective October 1, 2024, BCBS Wyoming will reject prior authorizations that use the non-specific dump code J3490 if the requested drug is listed on their Redirection of Care (ROC) list. Providers must use the appropriate specific HCPCS code instead of J3490 for these drugs to avoid rejections.
Action Required
Immediately: Billing team must stop using J3490 for prior authorization requests when the drug is on the BCBS Wyoming ROC list. Review the current ROC list and identify appropriate specific HCPCS codes for each drug. Update billing system to flag J3490 usage and require verification against ROC list. Train staff to use drug-specific HCPCS codes instead of J3490 to prevent prior authorization rejections.