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CommercialCoverageLow impact

Brineura (cerliponase alfa)

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

Summary

BCBSMS updated the Brineura (cerliponase alfa) policy for CLN2 disease treatment with revised age/weight requirements and refined diagnostic criteria. The policy now requires patients to be at least 37 weeks post-menstrual age and weigh at least 2.5 kg, with updated confirmation methods for CLN2 disease diagnosis.

Action Required

Action needed
Immediately: Review current Brineura patients to ensure they meet updated criteria (37+ weeks post-menstrual age, 2.5+ kg weight, and proper CLN2 diagnosis confirmation). Update patient eligibility verification processes to include new age/weight requirements. Ensure documentation includes required diagnostic testing (TPP1 enzyme deficiency or molecular analysis) for future claims.

Affected Billing Codes

J0567