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Independence Blue CrossCommercial · Billing Codes · Pharmacy · Oncology, Pulmonology, PharmacyMedium impact

08.02.27a, Tarlatamab-dlle (Imdelltra®) for intravenous use

Act
by Jun 15, 2026
Effective date
Jun 15, 2026
Identified
Jun 19, 2026

Summary

Independence Blue Cross updated Policy 08.02.27a to expand coverage of tarlatamab-dlle (Imdelltra) to include treatment of brain metastases in small cell lung cancer (SCLC) in addition to extensive stage SCLC. The policy replaced temporary HCPCS code C9170 and J3590 with permanent code J9026, and added ICD-10 code C79.31 for secondary brain malignancy. These changes align with updated NCCN compendium guidelines effective June 15, 2026.

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What to do

by Jun 15, 2026 · 6 steps
01Billing team must update billing system to recognize J9026 (Injection, tarlatamab-dlle, 1 mg) as the active HCPCS code for this drug.
02Remove or deactivate temporary codes C9170 and J3590 from billing software to prevent incorrect claim submissions.
03Add ICD-10 code C79.31 (Secondary malignant neoplasm of brain) to the diagnosis code list for tarlatamab-dlle claims.
04Update prior authorization protocols to include the expanded indications: limited brain metastases (initial treatment for select cases or recurrent treatment) and extensive brain metastases (primary or recurrent treatment with stable systemic disease).
05Train billing staff and providers on the new coverage criteria requiring ECOG performance status 0-2 documentation and confirmation that treatment is medically necessary per NCCN guidelines.
06Claims submitted with outdated codes or without proper documentation of the new criteria will be denied.

Codes mentioned

J9026C9170J3590C79.31

Original notice

08.02.27a, Tarlatamab-dlle (Imdelltra®) for intravenous use
medpolicy.ibx.com · Always check the source before changing claims.
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Related changes

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Related policy hubs

Independence Blue Cross policiesOncologyPulmonologyPharmacyCode J9026Code C9170Code J3590Code C79.31

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