Ramucirumab (Cyramza) (CPB 0883, reviewed 2026-06-03)

IMMEDIATELY (effective 2026-06-03): Billing team must implement mandatory precertification workflow for all ramucirumab (Cyramza) claims. (1) Update billing software to flag J9308 claims as requiring precertification before submission. (2) Train oncology/gastroenterology providers and front desk staff to initiate precertification calls to Aetna at (866) 752-7021 or fax (888) 267-3277 BEFORE ramucirumab administration begins. (3) Update encounter forms and EMR templates to include precertification requirement checklist. (4) Verify member eligibility and plan design before processing any ramucirumab claims. (5) For all approved cases, ensure dosing compliance with FDA-approved labeling per specialty pharmacy quantity limits documentation. (6) Document baseline AFP levels (ICD-10: C22.0) and EGFR mutation status (CPT 81235) in medical record before initial authorization. Claims submitted without completed precertification will be denied and require resubmission.