CommercialAdministrativeLow impact
08.02.21, ADAMTS13, recombinant-krhn (Adzynma)
Independence Blue Cross·PA · Hematology, Pediatrics·Medical Policy
We identified it
Jun 19, 2026
Summary
This is a reissue of Independence Blue Cross's existing policy on ADAMTS13, recombinant-krhn (Adzynma) with no substantive changes to coverage criteria, dosing, or billing requirements. The policy was reviewed and reissued on 05/28/2025 per the company's annual review process, but coverage remains identical to the prior version effective 07/15/2024.
Action Required
No immediate action required. This is a routine annual policy reissue with no changes to coverage, dosing, criteria, or billing codes. Billing team should verify internal systems already reflect the existing coverage criteria for Adzynma (J7171) for congenital TTP prophylaxis and on-demand treatment when biallelic ADAMTS13 mutations are confirmed and activity is <10%. Maintain current prior authorization workflows requiring hematologist prescription and documented clinical response for continuation. No claim processing changes are needed.