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CommercialPrior AuthMedium impact

Difelikefalin (Korsuva) Injection (CPB 1028, reviewed 2025-12-23)

Aetna·Nephrology, Pharmacy·Pharmacy
Effective date
Dec 23, 2025
We identified it
Aug 13, 2026
Days to comply

Summary

Aetna has issued a new clinical policy (CPB 1028, effective 2025-12-23) establishing coverage criteria for Difelikefalin (Korsuva) injection for moderate-to-severe pruritus in hemodialysis patients. The policy requires precertification, nephrology consultation, documented treatment failure of alternative therapies, and clinical response monitoring. Coverage excludes peritoneal dialysis patients.

Action Required

Action needed
By 2025-12-23, the billing team must: (1) Update billing system rules to require precertification for all Difelikefalin (Korsuva) claims using HCPCS code J0879 before submission to Aetna; (2) Configure system to flag claims for members on peritoneal dialysis and deny automatically as non-covered; (3) Create precertification checklist requiring documentation of: patient age ≥18, current hemodialysis status, baseline pruritus scoring (WI-NRS, VAS, or NRS), confirmation pruritus is not dialysis-session-only, failed/contraindicated trials of antihistamines/gabapentin/pregabalin/emollients, and dosage ≤0.5 mcg/kg per treatment (max 3/week); (4) Update encounter templates to require nephrology prescription/consultation; (5) Configure continuation-of-therapy rules to require documentation of ≥4-point improvement on WI-NRS from baseline; (6) Provide precertification contact information to providers (call 866-752-7021 or fax 888-267-3277); (7) Train billing and prior auth teams on these requirements. Claims submitted without precertification or missing required documentation will be denied.

Affected Billing Codes

J0879
96374
96375
96376
96377
96378
96379
L29.0
L29.1
L29.2
L29.3
L29.4
L29.5
L29.6
L29.7
L29.8
L29.9
Z99.2