CommercialCoverageMedium impact
Gene Therapy for the Treatment of Metachromatic Leukodystrophy
Blue Cross & Blue Shield of Mississippi·MS · Hematology, Pediatrics, Oncology +1 more·Medical Policy
Effective date
Jan 20, 2025
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield Mississippi has implemented a new policy declaring Lenmeldy (atidarsagene autotemcel), a gene therapy for metachromatic leukodystrophy, as not medically necessary due to unknown long-term durability. All services related to this treatment require prior authorization through BCBSMS PA review process or will be denied.
Action Required
Immediately: Billing team must flag HCPCS codes J3391 and J3590 as requiring prior authorization for BCBS Mississippi plans. Update billing system to alert staff that Lenmeldy (atidarsagene autotemcel) treatment and administration services need BCBSMS PA approval before submission. Claims submitted without prior authorization will be denied as not medically necessary.