Medicare AdvantagePrior AuthMedium impact
MA08.090i, Lanreotide (Somatuline Depot)
Independence Blue Cross·Endocrinology, Oncology, Gastroenterology·Medical Policy
Effective date
Sep 4, 2026
We identified it
Sep 5, 2026
Summary
Policy MA08.090i for Lanreotide (Somatuline Depot) has been updated with changes to medical necessity criteria and medical coding requirements, effective 09/04/2026. The billing team must review the full policy text to identify specific coding and prior authorization updates for this injectable somatostatin analog.
Action Required
By 09/04/2026: Billing team must access the full policy at https://medpolicy.ibx.com/ibc/ma/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=09&FilterField2=MPSiteActivityLogYear&FilterValue2=2026#medicare-advantage-ma08-090i-lanreotide-somatuline-depot to identify specific HCPCS codes (likely J3265 or similar for lanreotide), prior authorization requirements, and medical necessity criteria. Update billing system rules, prior authorization workflows, and provider documentation templates accordingly. Notify providers prescribing Somatuline Depot of any new prior auth requirements. Claims submitted without compliance may face denials or delays.