← Back to list
08.02.19b, Mirikizumab-mrkz (Omvoh®) for Intravenous Use
Effective date
Oct 19, 2026
Identified
Oct 20, 2026
Summary
Independence Blue Cross updated policy 08.02.19b for mirikizumab-mrkz (Omvoh) IV effective 10/19/2026. Coverage criteria were revised to align with updated ACG guidelines, removing conventional therapy requirements. Billing teams must now append modifier JA to indicate intravenous administration, and must use the reintroduced ICD-10 diagnosis codes for ulcerative colitis and Crohn's disease claims.
Get alerts when payers change rules like this one
We check Independence Blue Cross and other payers every day and email you when a change matches your specialty and state.
Get Independence Blue Cross alertsPolicy Monitoring is free. No card required.
What to do
Action · 5 steps
01Effective 2026-10-19: Billing team must implement the following changes.
02Append modifier JA (Administered Intravenously) to HCPCS code J2267 for all mirikizumab-mrkz IV claims in the billing system.
03Update billing software to require one of the listed ICD-10 diagnosis codes (K50.xx or K51.xx series) for Crohn's disease or ulcerative colitis when billing J2267.
04Remove any prior requirement for conventional therapy documentation before processing claims, as the policy no longer mandates this criterion.
05Verify that claims submitted include proper gastroenterology provider documentation and confirm members meet the medical necessity criteria (age 18+, moderately to severely active disease, no concurrent biologic DMARD therapy, prescribed by gastroenterology provider).
If missed: Failure to append modifier JA or use appropriate diagnosis codes may result in claim denials.
Codes mentioned
J2267K50.00K50.011K50.012K50.013K50.014K50.018K50.019K50.10K50.111K50.112K50.113K50.114K50.118K50.119K50.80K50.811K50.812K50.813K50.814K50.818K50.819K50.90K50.911K50.912K50.913K50.914K50.918K50.919K51.00K51.011K51.012K51.013K51.014K51.018K51.019K51.20K51.211K51.212K51.213K51.214K51.218K51.219K51.30K51.311K51.312K51.313K51.314K51.318K51.319K51.50K51.511K51.512K51.513K51.514K51.518K51.519K51.80K51.811K51.812K51.813K51.814K51.818K51.819K51.90K51.911K51.912K51.913K51.914K51.918K51.919
Original notice
08.02.19b, Mirikizumab-mrkz (Omvoh®) for Intravenous Use
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
See all Independence Blue Cross changes →MA08.169b, Mirikizumab-mrkz (Omvoh®) for Intravenous UseMediumEffective Oct 19, 2026 · Pharmacy08.01.95d, Risankizumab-rzaa (Skyrizi®) for Intravenous UseMediumEffective Oct 5, 2026 · PharmacyMA08.153d, Risankizumab-rzaa (Skyrizi®) for intravenous useMediumEffective Oct 5, 2026 · Pharmacy08.00.64i, Natalizumab (Tysabri®) and Related BiosimilarsMediumEffective Oct 1, 2025 · PharmacyBrowse every Independence Blue Cross change in the policy list
Related policy hubs
Independence Blue Cross policiesGastroenterologyPharmacyCode J2267Code K50.00Code K50.011Code K50.012Code K50.013Code K50.014Code K50.018Code K50.019Code K50.10Code K50.111Code K50.112Code K50.113Code K50.114Code K50.118Code K50.119Code K50.80Code K50.811Code K50.812Code K50.813Code K50.814Code K50.818Code K50.819Code K50.90Code K50.911Code K50.912Code K50.913Code K50.914Code K50.918Code K50.919Code K51.00Code K51.011Code K51.012Code K51.013Code K51.014Code K51.018Code K51.019Code K51.20Code K51.211Code K51.212Code K51.213Code K51.214Code K51.218Code K51.219Code K51.30Code K51.311Code K51.312Code K51.313Code K51.314Code K51.318Code K51.319Code K51.50Code K51.511Code K51.512Code K51.513Code K51.514Code K51.518Code K51.519Code K51.80Code K51.811Code K51.812Code K51.813Code K51.814Code K51.818Code K51.819Code K51.90Code K51.911Code K51.912Code K51.913Code K51.914Code K51.918Code K51.919