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Independence Blue CrossCommercial · Coverage · Medical Policy · PA · General Surgery, Transplant Surgery, GastroenterologyLow impact

11.04.01e, Islet Cell Transplantation, including use of Donislecel-jujn (Lantidra)

Effective date
Feb 26, 2024
Identified
Jun 19, 2026

Summary

Independence Blue Cross reissued policy 11.04.01e to reaffirm coverage positions on islet cell transplantation. Autologous islet cell transplantation remains covered only as an adjunct to total/near-total pancreatectomy for chronic pancreatitis; allogeneic islet cell transplantation, including FDA-approved Lantidra (donislecel-jujn), remains experimental/investigational and not covered. No changes to covered services or billing codes; this is a routine policy reaffirmation.

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What to do

Action · 5 steps
01No immediate action required.
02Billing team should be aware that the policy position has not changed: claims for autologous islet cell transplantation (CPT 0584T, 0585T, 0586T, 48160, or HCPCS G0341, G0342, G0343) are covered only when documented as an adjunct to pancreatectomy for chronic pancreatitis (ICD-10 K86.0, K86.1).
03All claims for allogeneic islet cell transplantation, including those using codes C9399, J3490, or J3590 for Lantidra (donislecel-jujn), must be denied as experimental/investigational.
04Continue denying any S2102 claims.
05Ensure denial letters cite experimental/investigational status per this policy.

Codes mentioned

48160G0341G0342G0343S2102C9399J3490J3590K86.0K86.1Z90.410Z90.411

Original notice

11.04.01e, Islet Cell Transplantation, including use of Donislecel-jujn (Lantidra)
medpolicy.ibx.com · Always check the source before changing claims.
View original ↗

Related changes

See all Independence Blue Cross changes →
MA11.007b, Islet Cell Transplantation, including use of Donislecel-jujn (Lantidra)LowEffective Feb 26, 2024 · Medical PolicyMA11.007b, Islet Cell Transplantation, including use of Donislecel-jujn (Lantidra)MediumEffective Feb 26, 2024 · Medical Policy11.04.01e, Islet Cell Transplantation, including use of Donislecel-jujn (Lantidra)MediumEffective Feb 26, 2024 · Medical PolicyMA08.007ax, Medicare Part B vs. Part D Crossover DrugsMediumEffective Aug 30, 2026 · PharmacyBrowse every Independence Blue Cross change in the policy list

Related policy hubs

Independence Blue Cross policiesPA policy changesGeneral SurgeryTransplant SurgeryGastroenterologyCode 48160Code G0341Code G0342Code G0343Code S2102Code C9399Code J3490Code J3590Code K86.0Code K86.1Code Z90.410Code Z90.411

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