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08.02.14a, Casgevy™ (exagamglogene autotemcel)
Effective date
Jul 1, 2025
Identified
Jun 19, 2026
Summary
Independence Blue Cross reissued Policy 08.02.14a for Casgevy (exagamglogene autotemcel) with no substantive changes to coverage criteria. The policy continues to cover this gene therapy for severe sickle cell disease and transfusion-dependent β-thalassemia in patients aged 12+ who meet strict medical necessity requirements. No billing or documentation workflow changes are required.
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What to do
Action · 4 steps
01No immediate action required.
02This is a routine annual reissue with no changes to medical necessity criteria, coverage determination, or billing guidelines.
03Billing team should file this updated policy version in the IBC policy repository for reference, but existing authorization and billing processes for Casgevy claims remain unchanged.
04Ensure current Casgevy prior authorization templates and criteria remain active without modification.
Codes mentioned
J3392D56.1D57.00D57.01D57.02D57.03D57.04D57.09
Original notice
08.02.14a, Casgevy™ (exagamglogene autotemcel)
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
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