CommercialPrior AuthHigh impact
Belantamab Mafodotin-blmf (Blenrep) (CPB 0981, reviewed 2026-02-06)
Aetna·Oncology, Hematology·Medical Policy
Effective date
Jul 1, 2026
We identified it
Aug 12, 2026
Summary
Aetna has updated its clinical policy for Belantamab Mafodotin-blmf (Blenrep) effective July 1, 2026, establishing new precertification requirements for all participating providers and members. The policy defines coverage criteria for multiple myeloma, POEMS syndrome, MIDD, and MGRS, with specific prior treatment thresholds and combination therapy requirements. Precertification is now mandatory for this drug, requiring calls to (866) 752-7021 or faxes to (888) 267-3277.
Action Required
By July 1, 2026: Billing and clinical teams must implement mandatory precertification workflows for Belantamab Mafodotin-blmf (Blenrep) for all Aetna commercial plan members. Update billing system to flag all claims with ICD-10 codes C90.00, C90.01, C90.02, D47.2, or D47.Z9 requiring precertification before submission. Providers must obtain precertification by calling (866) 752-7021 or faxing (888) 267-3277 with Statement of Medical Necessity (SMN) precertification forms (available at Specialty Pharmacy Precertification). Verify patients meet coverage criteria: for multiple myeloma, patient must have received at least 2 prior lines of therapy (including proteasome inhibitor and immunomodulatory agent) for combination therapy, or 3+ lines for monotherapy; for POEMS/MIDD/MGRS, single agent or combination use is covered. Document prior therapy history in precertification request. Update encounter forms and billing software rules to prevent claims submission without prior auth approval. Failure to obtain precertification will result in claim denials.