CommercialPrior AuthMedium impact
08.02.00c, Mosunetuzumab-axgb (Lunsumio™)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Jun 16, 2025
We identified it
Jun 19, 2026
Summary
A new policy for Mosunetuzumab-axgb (Lunsumio™) has been implemented with updated medical necessity criteria and medical coding requirements. This affects coverage and billing for this specialty oncology medication used in treating certain blood cancers.
Action Required
By June 16, 2025: Billing team must review and implement new medical necessity criteria for Mosunetuzumab-axgb (Lunsumio™) claims. Update prior authorization workflows and documentation requirements per the new policy. Providers must ensure proper medical coding compliance for this specialty oncology drug to avoid claim denials.