Sept. 28, 2022

Applying medical policy criteria completely and accurately is critical to ensure benefits and reimbursement are applied correctly to our members’ claims. Beginning Dec. 1, 2022, BlueCross BlueShield of South Carolina will implement the following medical policies:

1. Fasenra^® (Benralizumab)                                    CAM 354
2. Prolia^® (Denosumab)                                          CAM 355
3. Xgeva^® (Denosumab)                                          CAM 356
4. Nexviazyme™ (Avalglucosidase alfa-ngpt)         CAM 359
5. Durysta™ (Bimatoprost Implant)                         CAM 360
6. Nulojix^® (Belatacept)                                          CAM 361
7. Vabysmo™ (Faricimab-svoa)                                CAM 362

Each policy contains medical necessity criteria used to determine coverage. Criteria could include age limitations, specific diagnosis requirements and more. For this reason, it is important to review each policy closely.

We recommend frequently visiting the Medical Policies pages to remain abreast of any policy updates.

If you have any questions, please feel free to contact the provider education team at 803-264-4730.