Policy library / J9282 Commercial payer policies listing J9282 6 policies from 6 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.
Arkansas Blue Cross and Blue Shield policies listing J9282, with the code’s status in each Policy Effective Status of J9282 Mitomycin Intravesical Solution (e.g., Zusduri) PayerPolicy · ARKBLUE-MITOMYCIN-INTRAVESICAL-SOLUTION-E-G-ZUSDURI Not recorded Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.
BlueCross BlueShield of Tennessee policies listing J9282, with the code’s status in each Policy Effective Status of J9282 Mitomycin (Zusduri) PayerPolicy · BCBSTN-0b2495143c Dec 2, 2025 Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.
Cigna policies listing J9282, with the code’s status in each Policy Effective Status of J9282 Cigna MedOnc Master Drug List.pdf PayerPolicy · EVICORE-HPLAN-CIGNA-18A0ACC73CE9 Not recorded Prior auth required
Health Net Oregon policies listing J9282, with the code’s status in each Policy Effective Status of J9282 Mitomycin Instillation Solution (Jelmyto, Zusduri); CP.PHAR.495 PayerPolicy · HEALTHNET_OR-CP-PHAR-495 Not recorded Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.
Health Partners Plans / Jefferson Health Plans policies listing J9282, with the code’s status in each Policy Effective Status of J9282 Q4 - 2026 JHP MedOnc Master Drug List.pdf PayerPolicy · EVICORE-HPLAN-HEALTH_PARTNERS_PLANS-39BC225341EE Not recorded Prior auth required
Moda Health policies listing J9282, with the code’s status in each Policy Effective Status of J9282 Zusduri (mitomycin) PayerPolicy · MODA-ZUSDURI-D137427D83 Not recorded Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.