Policy library / J9054 Commercial payer policies listing J9054 8 policies from 8 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
Codes labeled “Inferred from policy title” are not listed in the policy document; Backwork attached them because the policy title names the drug.
BlueCross BlueShield of Tennessee policies listing J9054, with the code’s status in each Policy Effective Status of J9054 Bortezomib (Velcade; Bortezomib, Boruzu) PayerPolicy · BCBSTN-7839defca4 Jul 9, 2005 Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.
Cigna policies listing J9054, with the code’s status in each Policy Effective Status of J9054 Cigna MedOnc Master Drug List.pdf PayerPolicy · EVICORE-HPLAN-CIGNA-18A0ACC73CE9 Not recorded Prior auth required
Health Net Oregon policies listing J9054, with the code’s status in each