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Marnetegragene Autotemcel (Kresladi) (CPB 1102)
Effective date
Not stated in the notice
Identified
Oct 6, 2026
Summary
Aetna's Clinical Policy Bulletin 1102 addresses marnetegragene autotemcel (Kresladi) for commercial medical plans, and it points to the Medicare Part B criteria for Medicare. Precertification is required of all Aetna participating providers and members in applicable plan designs, through National Medical Excellence at 877-212-8811. Unless the member's health plan has elected not to require it, gene and cellular therapies must be administered at an Aetna Institutes GCIT Network, and Aetna considers the one-time administration medically necessary when all listed LAD-I criteria are met.
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What to do
Action · 4 steps
01Billing team: get precertification for Kresladi through National Medical Excellence at 877-212-8811.
02Confirm the prescriber is an immunologist, hematologist, or physician who specializes in LAD-I, or is consulting with one.
03Confirm the member is 9 months to less than 10 years of age, has severe LAD-I confirmed by biallelic pathogenic ITGB2 variants, is an appropriate candidate for hematopoietic stem cell transplant, has no medically-eligible HLA-matched sibling donor, and has not received Kresladi or any other gene therapy previously.
04Unless the health plan has elected not to require it, administer the therapy at an Aetna Institutes GCIT Designated Network.
Codes mentioned
382043823038232800698007682565844508446085002850048500785025850278504986689867018670286703873898739087391887209641396415D71.1B20B97.33B97.34B97.35C91.50C91.51C91.52Z22.6Z99.2
Original notice
Marnetegragene Autotemcel (Kresladi) (CPB 1102)
aetna.com · Always check the source before changing claims.
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Related policy hubs
Aetna policiesAllergy & ImmunologyHematologyCode 38204Code 38230Code 38232Code 80069Code 80076Code 82565Code 84450Code 84460Code 85002Code 85004Code 85007Code 85025Code 85027Code 85049Code 86689Code 86701Code 86702Code 86703Code 87389Code 87390Code 87391Code 88720Code 96413Code 96415Code D71.1Code B20Code B97.33Code B97.34Code B97.35Code C91.50Code C91.51Code C91.52Code Z22.6Code Z99.2