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08.01.35k, Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)
Act
by Jan 1, 2026
Effective date
Jan 1, 2026
Identified
Jun 19, 2026
Summary
Independence Blue Cross reissued Policy 08.01.35k on the Rylaze® (asparaginase erwinia chrysanthemi recombinant-rywn) with no substantive coverage changes. The old HCPCS code J9019 for Erwinaze (discontinued product) has been removed and replaced with J9021 for Rylaze. Coverage criteria remain unchanged: Rylaze is covered for ALL and lymphoblastic lymphoma (age 1+ months) and extranodal NK/T-cell lymphomas in adults when used in multi-agent chemotherapy and only after documented E. coli-derived asparaginase hypersensitivity.
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What to do
by Jan 1, 2026 · 5 steps
01Billing team must remove HCPCS code J9019 (Erwinaze) from all billing systems and encounter forms—this code is no longer valid and claims submitted with this code will be denied.
02Update billing software to recognize and process only HCPCS code J9021 (Rylaze) for asparaginase ervinia chrysanthemi recombinant claims.
03Oncology providers and pharmacy staff must verify that all Rylaze requests include documentation of prior E.
04coli-derived asparaginase hypersensitivity and confirm absence of contraindications (serious prior hypersensitivity to Rylaze, pancreatitis, hemorrhage/thrombosis, severe hepatic impairment).
05Update clinical decision support and prior authorization workflows to reflect that coverage is limited to ALL, lymphoblastic lymphoma (pediatric and adult age 1+ months), and extranodal NK/T-cell lymphomas (adults only).
If missed: Failure to update billing codes will result in claim denials and may require manual correction and resubmission.
Codes mentioned
J9019J9021
Original notice
08.01.35k, Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)
medpolicy.ibx.com · Always check the source before changing claims.
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