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08.01.87a, Sutimlimab-jome (Enjaymo)

Independence Blue Cross·Hematology, Internal Medicine, Pharmacy·Pharmacy
Effective date
Not stated
We identified it
Jun 19, 2026
Days to comply
—

Summary

This is a reissue with no changes to the Sutimlimab-jome (Enjaymo) policy. Independence Blue Cross has reviewed and reaffirmed its coverage position for this drug used to treat hemolysis in adults with cold agglutinin disease. The HCPCS code J1302 remains the active billing code; no new coverage criteria or billing changes have been implemented.

Action Required

Action needed
No immediate action required. This is a reissue with no substantive changes to coverage criteria, billing codes, or documentation requirements. Billing teams should retain current procedures for claims using HCPCS code J1302 for sutimlimab-jome. Verify that legacy code C9094 and J3590 are no longer used in billing systems (these were removed as of 10/01/2022). No workflow modifications are necessary.

Affected Billing Codes

J1302

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