E76.210 Insurance Policy Changes

ICD-10 E76.210 is officially defined as "Morquio A mucopolysaccharidoses." code E76.210 is referenced in 5 tracked payer policy changes from Blue Cross Blue Shield of North Dakota, Aetna, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code E76.210 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Blue Cross Blue Shield of North Dakota · Identified Oct 24, 2026High impact
Pharmacy Policies Available Online
Blue Cross Blue Shield of North Dakota's October 22, 2026 pharmacy policy update lists Commercial and Medicaid Expansion pharmacy policy changes with several different effective dates, including November 1 and December 1, 2026. Effective December 1, 2026, the intravitreal injection policy adds HCPCS code J3490 for Ranluspec, the portable external infusion pump policy adds codes A4228 and E0788, and the therapeutic radiopharmaceuticals policy for neuroendocrine tumors removes Iobenguane I 131 (A9590) and associated codes 77300, 78804, 96365 and 96374, because the manufacturer withdrew the product from the market. The notice also lists new Medicaid Expansion prior authorization policies for five drugs effective December 1, 2026, and says three Medicaid Expansion policies will be retired on that date.
Aetna · Identified Aug 16, 2026Medium impact
Lysosomal Storage Disorder Treatments (CPB 0442, reviewed 2026-07-08)
Aetna's commercial policy for lysosomal storage disorder treatments covers each enzyme replacement drug for the diagnoses and criteria listed, including Fabry disease, Pompe disease, Gaucher disease, MPS I, II, IVA, VI and VII, CLN2, acid sphingomyelinase deficiency, lysosomal acid lipase deficiency and alpha-mannosidosis. Lumizyme and Pombiliti are medically necessary only for members who have a contraindication, intolerance or ineffective response to Nexviazyme, and VPRIV is medically necessary only for members who have a contraindication, intolerance or ineffective response to both Cerezyme and Elelyso. Continuation of therapy is covered only for members who are responding to therapy.
Independence Blue Cross · Effective Apr 1, 2026Low impact
08.00.70e, Enzyme Replacement Therapy for Mucopolysaccharidosis (e.g., Aldurazyme®, Elaprase®, Vimizim®, Naglazyme®, Mepsevii™, etc.)
This is a routine annual reissue of the Enzyme Replacement Therapy for Mucopolysaccharidosis policy with no substantive changes to coverage criteria, dosing, or billing codes. The policy maintains coverage for five ERT medications (Aldurazyme, Elaprase, Vimizim, Naglazyme, Mepsevii) with existing medical necessity requirements and FDA-approved dosing schedules.
Independence Blue Cross · Identified Jun 19, 2026Low impact
MA08.034d, Enzyme Replacement Therapy for Mucopolysaccharidosis (e.g., Aldurazyme®, Elaprase®, Vimizim®, Naglazyme®, Mepsevii™, etc.)
This is a routine annual reissue of Independence Blue Cross Medicare Advantage policy MA08.034d with NO substantive changes to coverage criteria, medical necessity requirements, dosing, or billing codes for enzyme replacement therapy for mucopolysaccharidosis (MPS). The policy remains effective 01/01/2024 and applies to New Jersey Medicare Advantage members only. No billing workflow changes are required.
Independence Blue Cross · Identified Jun 19, 2026Low impact
08.00.70e, Enzyme Replacement Therapy for Mucopolysaccharidosis (e.g., Aldurazyme®, Elaprase®, Vimizim®, Naglazyme®, Mepsevii™, etc.)
This is a routine annual reissue of Independence Blue Cross policy 08.00.70e on Enzyme Replacement Therapy for Mucopolysaccharidosis with no substantive changes to coverage criteria, dosing, or billing codes. The policy maintains coverage for five FDA-approved enzyme replacement therapies (Aldurazyme, Elaprase, Vimizim, Naglazyme, and Mepsevii) when medical necessity criteria are met.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code E76.210?

There are 5 tracked policy changes affecting code E76.210, including updates from Blue Cross Blue Shield of North Dakota, Aetna, Independence Blue Cross. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code E76.210?

Payers that have issued tracked updates for code E76.210 include: Blue Cross Blue Shield of North Dakota, Aetna, Independence Blue Cross.

How do I get notified when code E76.210 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code E76.210. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for code E76.210?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

All billing codes J3590 C9399 J3490 99215 99213 99202

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Pharmacy Policies Available Online

Lysosomal Storage Disorder Treatments (CPB 0442, reviewed 2026-07-08)

08.00.70e, Enzyme Replacement Therapy for Mucopolysaccharidosis (e.g., Aldurazyme®, Elaprase®, Vimizim®, Naglazyme®, Mepsevii™, etc.)

MA08.034d, Enzyme Replacement Therapy for Mucopolysaccharidosis (e.g., Aldurazyme®, Elaprase®, Vimizim®, Naglazyme®, Mepsevii™, etc.)

08.00.70e, Enzyme Replacement Therapy for Mucopolysaccharidosis (e.g., Aldurazyme®, Elaprase®, Vimizim®, Naglazyme®, Mepsevii™, etc.)

What insurance policy changes affect code E76.210?

Which payers have updated policy for code E76.210?

How do I get notified when code E76.210 policy changes?

Why do payers change policies for code E76.210?