CommercialCoverageMedium impact
08.00.59d, Loncastuximab tesirine-lpyl (Zynlonta®)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Nov 17, 2025
We identified it
Jun 19, 2026
Summary
Commercial insurance policy for Loncastuximab tesirine-lpyl (Zynlonta®) has been updated with new medical necessity criteria and general guidelines. This affects coverage determination and billing requirements for this specialty oncology medication.
Action Required
By November 17, 2025: Billing team must review updated medical necessity criteria for Loncastuximab tesirine-lpyl (Zynlonta®) coverage. Providers must ensure documentation meets new criteria requirements before submitting claims. Update prior authorization workflows if applicable to prevent claim denials.