CommercialBilling CodesMedium impact
08.01.26e, Enzyme Replacement Therapy for Adenosine Deaminase Severe Combined Immune Deficiency (e.g., elapegademase-lvlr [Revcovi])
Independence Blue Cross·Allergy & Immunology, Pediatrics, Infectious Disease +1 more·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jul 9, 2026
Summary
Independence Blue Cross reissued policy 08.01.26e with no substantive changes to elapegademase-lvlr (Revcovi) coverage for ADA-SCID treatment. However, HCPCS code J2504 (pegademase bovine) was deleted effective 01/01/2026 because pegademase bovine is no longer manufactured and has been withdrawn from the market. Billing teams must stop using J2504 immediately and ensure no claims are submitted under this code.
Action Required
Immediately: Billing team must update billing system to prohibit submission of HCPCS code J2504 (pegademase bovine). Remove J2504 from all active billing templates, encounter forms, and billing software charge capture screens. Verify no outstanding claims use J2504 and correct any submitted claims if necessary. Claims submitted with J2504 will be denied as this code is no longer eligible for reimbursement. For elapegademase-lvlr (Revcovi), continue using HCPCS codes C9399 or J3590 for claims. Providers should be notified that pegademase bovine is no longer covered due to market withdrawal.