Summary
Independence Blue Cross reissued Policy 08.02.22 on 2026-10-28 with no substantive changes to communicate the company's continuing position on lifileucel (Amtagvi) coverage for unresectable or metastatic melanoma. The policy remains effective from its original date of 2024-10-21 and continues to cover lifileucel as second-line or subsequent therapy after progression on PD-1 inhibitors and BRAF inhibitors, subject to specified clinical criteria.
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What to do
Action · 5 steps
01No immediate action required.
02This is a reissue with no changes to the coverage criteria, medical necessity conditions, or billing codes.
03The policy has been in effect since 2024-10-21 and continues unchanged.
04Billing team should verify that current claim processing workflows for lifileucel (Amtagvi) under codes C9399 and J3590 align with the stated coverage criteria (second-line therapy, ECOG 0-1, resectable lesion minimum 1.5 cm post-resection, adequate organ function, and exclusion criteria including prior cell transfer therapy).
05No updates to billing systems, prior authorization processes, or documentation requirements are needed based on this reissue.
Codes mentioned
C9399J3590C43.0C43.111C43.112C43.121C43.122C43.21C43.22C43.30C43.31C43.39
Original notice
08.02.22, Lifileucel (Amtagvi™)
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
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