CommercialCoverageMedium impact
08.00.21a, Givosiran (Givlaari) and Panhematin (Hemin)
Independence Blue Cross·Hematology, Gastroenterology, Internal Medicine·Medical Policy
Effective date
May 19, 2025
We identified it
Jun 19, 2026
Summary
Updated medical policy for Givosiran (Givlaari) and Panhematin (Hemin) with changes to medical necessity criteria, coding requirements, and general guidelines. This affects billing and coverage determination for these specialized medications used in treating acute hepatic porphyria.
Action Required
By May 19, 2025: Review updated medical necessity criteria for Givosiran and Panhematin claims. Update billing system documentation requirements and coding practices per new guidelines. Ensure providers document appropriate medical necessity criteria for these specialty medications to prevent claim denials.