CommercialBilling CodesHigh impact
Pharmacy Policy Updates
Blue Cross Blue Shield of North Dakota·ND · Oncology, Hematology, Gastroenterology +3 more·Pharmacy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
BCBS North Dakota updated medical pharmacy billing codes effective January 1, 2026, adding 7 new HCPCS J-codes for new drugs and deleting 4 discontinued codes. Retail pharmacy prior authorization requirements were also updated for biologic immunomodulators and other specialty medications effective February 1, 2026.
Action Required
By January 1, 2026: Billing team must update billing software to include new J-codes (J9282, Q5160, J9184, J3389, J9256, J9326, J3387) and remove discontinued codes (J9019, J1572, J0172, J1562). By February 1, 2026: Update prior authorization requirements for biologic immunomodulators, Hepatitis C antivirals, and Zeposia - verify new failure requirements and pediatric weight restrictions before submitting claims.