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CommercialPrior AuthLow impact

Koselugo (selumetinib)

Blue Cross & Blue Shield of Mississippi·MS · Oncology, Neurology, Pediatrics·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

The policy for Koselugo (selumetinib) has been updated to expand age eligibility from 1 year and older (previously 2-18 years) and clarify that drug samples cannot be used to satisfy prior authorization requirements. Prior authorization remains required for all patients with neurofibromatosis type 1 (NF1) who have symptomatic, inoperable plexiform neurofibromas.

Action Required

Action needed
Immediately: Update prior authorization forms and billing system notes for Koselugo (selumetinib) to reflect expanded age eligibility (1 year and older, not 2-18 years). Ensure staff know that drug samples cannot be used to satisfy prior authorization requirements. Verify all NF1 patients with plexiform neurofibromas have proper prior auth before billing HCPCS J8499.

Affected Billing Codes

J8499