Medical Policy and Coding Updates September 2020

  • Updates for both non-individual and individual plans

  • Effective December 3, 2020

    Hematopoietic Cell Transplantation for Hodgkin Lymphoma, 8.01.29

    Criteria updated

    • Tandem autologous hematopoietic cell transplantation (HCT) medical necessity criteria have been removed
    • Tandem autologous hematopoietic cell transplantation (HCT) is now considered investigational in patients with Hodgkin lymphoma

    Miscellaneous Oncology Drugs, 5.01.540

    New drugs added to policy

    • Blincyto® (blinatumomab)
      • Treatment of adults and children for B-cell precursor acute lymphoblastic leukemia (ALL) in first or second complete remission with minimal residual disease (MRD)
      • Treatment of adults and children with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL)
    • Leukine® (sargramostim)
      • Treatment of acute myeloid leukemia after induction chemotherapy
      • Mobilization and following transplant of autologous peripheral blood progenitor cells
      • Myeloid reconstitution after (allogenic or autologous) bone marrow transplant
      • Treatment for bone marrow transplant (allogenic or autologous) failure or engraftment delay
      • Treatment for exposure to myelosuppressive doses of radiation (Hematopoietic Syndrome of Acute Radiation Syndrome)

    Use of Vascular Endothelial Growth Factor Receptor (VEGF) Inhibitors and Other Angiogenesis Inhibitors in Oncology Treatment, 5.01.517

    New drugs added to policy

    • Cyramza® (ramucirumab)
      • Treatment of advanced or metastatic gastric or gastro-esophageal junction (GEJ) cancer that has continued to grow while on or after prior fluoropyrimidine- or platinum- containing chemotherapy when used as a single agent or with paclitaxel
      • Treatment of metastatic non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) gene changes (exon 19 or exon 21) as first-line therapy when used with erlotinib
      • Treatment of metastatic non-small cell lung cancer (NSCLC) that has continued to grow while on or after platinum-based chemotherapy when used with docetaxel
      • Treatment of metastatic colorectal cancer (mCRC) that has continued to grow while on or after prior therapy with bevacizumab, oxaliplatin, and a fluoropyrimidine when used with a FOLFIRI chemotherapy combination
      • Treatment of hepatocellular carcinoma (HCC) in patients who have an elevated alpha fetoprotein and have been treated with sorafenib when used as a single agent

    Effective October 2, 2020

    Miscellaneous Oncology Drugs, 5.01.540

    New drugs added to policy

    • Kyprolis® (carfilzomib)
      • Treatment of multiple myeloma
    • Velcade® (bortezomib)
      • Treatment of multiple myeloma and mantle cell lymphoma

    Pharmacotherapy of Arthropathies, 5.01.550

    Site of service review added

    • Avsola™ (infliximab-axxq)

    Pharmacotherapy of Inflammatory Bowel Disorder, 5.01.563

    Site of service review added

    • Avsola™ (infliximab-axxq)

    Pharmacologic Treatment of Infertility, 5.01.610

    New policy

    The following drugs have been added and may be considered medically necessary when criteria are met:

    • Brand Chorionic Gonadotropin
    • Bravelle® (urofollitropin)
    • Follistim® AQ (follitropin beta)
    • Pregnyl® (chorionic gonadotropin)

    Prostate Cancer Targeted Therapies, 5.01.544

    New drugs added to policy

    • Jevtana® (cabazitaxel)
    • Xofigo® (radium Ra 223 dichloride)

    Rituximab Non-Oncologic and Miscellaneous Uses, 5.01.556

    Site of service review added

    • Ruxience™ (rituximab-pvvr)

    Effective September 4, 2020

    Folate Antimetabolites, 5.01.617

    New policy

    The following drugs have been added and may be considered medically necessary when criteria are met:

    • Alimta® (pemetrexed)
      • In combination with Keytruda® (pembrolizumab) and platinum chemotherapy for the initial treatment of metastatic non-squamous non-small cell lung cancer (NSCLC)
      • In combination with cisplatin for the initial treatment of locally advanced or metastatic, non-squamous NSCLC
      • As a single agent for the maintenance treatment of locally advanced or metastatic, non-squamous NSCLC in patients whose disease has not progressed after four cycles of platinum-based first-line chemotherapy
      • As a single agent for the treatment of recurrent, metastatic non-squamous, NSCLC after prior chemotherapy
      • Initial treatment, in combination with cisplatin, of malignant pleural mesothelioma in patients whose disease can’t be surgically treated or who are not candidates for curative surgery
    • Folotyn® (pralatrexate)
      • Treatment of relapsed or refractory peripheral T-cell lymphoma (PTCL)

    Pharmacologic Treatment of Gout, 5.01.616

    New policy

    The following drug has been added and may be considered medically necessary when criteria are met:

    • Krystexxa® (pegloticase)
      • Treatment of chronic gout in patients age 18 and older

    No updates this month

    Revised pharmacy policies

    Effective September 1, 2020

    Excessively High Cost Drug Products with Lower Cost Alternatives, 5.01.560

    New drug added to policy

    • Mytesi® (crofelemer)
      • Treatment of non-infectious diarrhea in adults 18 or older

    Product change

    • For the topical lidocaine products list, Lidoderm® (lidocaine patch), Synera® (lidocaine and tetracaine patch), ZTlido™ (lidocaine topical system), and Paingo KFT (lidocaine/prilocaine), prior trial of lidocaine lotion has been changed to lidocaine ointment since the lotion is no longer available

    Miscellaneous Oncology Drugs, 5.01.540

    New drugs added to policy

    • Blenrep™ (belantamab mafodotin-blmf)
      • Treatment of adult patients with relapsed or refractory multiple myeloma who have received at least 4 prior therapies
    • Darzalex Faspro™ (daratumumab and hyaluronidase-fihj)
      • As a first-line therapy in adults with relapsed or refractory multiple myeloma who have received at least one prior therapy and when used with lenalidomide and dexamethasone
      • As a first-line therapy for adults with multiple myeloma when used with bortezomib, melphalan and prednisone
      • Treatment of adults with multiple myeloma who have received at least one prior therapy and when used with bortezomib and dexamethasone
      • Treatment of adults with multiple myeloma who have received at least three prior lines of therapy including a proteasome inhibitor (PI) and an immunomodulatory agent, or who are treatment-resistant to a PI and an immunomodulatory agent

    Drugs with new indications

    • Tazverik™ (tazemetostat)
      • Treatment of adults with relapsed or refractory follicular lymphoma whose tumors are positive for an EZH2 (enhancer of zeste homolog 2 protein) mutation as detected by an FDA-approved test and who have received at least 2 prior systemic therapies
      • Treatment of adults with relapsed or refractory follicular lymphoma who have no alternative treatment options
    • Xpovio™ (selinexor)
      • Treatment of adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specified, including DLBCL arising from follicular lymphoma, after at least 2 lines of systemic therapy

    Added codes

    Effective September 4, 2020

    Pharmacologic Treatment of Gout, 5.01.616
    Now requires review for medical necessity and prior authorization.

    J2507

    Folate Antimetabolites, 5.01.617
    Now requires review for medical necessity and prior authorization.

    J9305, J9307


    Effective September 1, 2020

    Serum Biomarker Panel Testing for Systemic Lupus Erythematosus and Other Connective Tissue Diseases, 2.04.123
    Now requires review for investigative.

    0062U

    Removed codes

    Effective September 1, 2020

    Amniotic Membrane and Amniotic Fluid Injections, 7.01.583
    No longer requires review for medical necessity and prior authorization.

    65778, 65779

  • Updates for non-individual plans only

  • No updates this month

    No updates this month

  • Updates for individual plans only

  • No updates this month

    No updates this month

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