| Effective May 1, 2025, Blue Cross Blue Shield of Wyoming (BCBSWY) will add the following medication to the Redirection of Care program. Saphnelo (HCPCS Code J0491) Saphnelo is a prescription medicine used to treat adults with moderate to severe SLE who are receiving other lupus medicines. BCBSWY Medical Policy 12.01.002 has been updated with the following information. There is no change in the medical necessity criteria. However, a tagline will be added to the top of the medical policy to notate that this medication is a part of the Redirection of Care program as of 5/1/2025. Click here to view the whole medical policy. FEP Medical Policy 5.99.023 has also been updated accordingly. Click here to view the whole medical policy. As a reminder, information related to the Redirection of Care program can be found on our website at SITE OF CARE INFUSION DRUGS. For questions regarding these changes please contact Provider Relations at 1-888-666-5188 or email provider.relations@bcbswy.com. |
Register NOW! Understanding Labs Webinar
| Register NOW! Understanding Labs Webinar Click below to register for the upcoming Understanding Labs Webinar 12 p.m. – 1 p.m. MST, Wed., April 23, 2025 · Learn about laboratory benefits including cost share, medically unlikely edits, and frequency limitations. · We’ll cover how to bill, what modifiers affect payment, and where to bill a claim for labs utilizing the BlueCard System. · Understand how CLIA Certificate of Waiver effects reimbursement and coding requirements. · How BCBSWY is educating members, so they understand that not all labs are preventive. |
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