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08.01.35i, Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)
Act
by Jan 1, 2025
Effective date
Jan 1, 2025
Identified
Jun 19, 2026
Summary
Independence Blue Cross updated policy 08.01.35i to version 08.01.35k, effective 01/01/2025. The old Erwinaze® (asparaginase erwinia chrysanthemi) drug and its HCPCS code J9010 are no longer reimbursable as the drug is discontinued. Coverage criteria for the replacement drug Rylaze® (recombinant-rywn) remain medically necessary for ALL, lymphoblastic lymphoma, and extranodal NK/T-cell lymphomas when used in multi-agent chemotherapy regimens for patients with documented E. coli-derived asparaginase hypersensitivity and no contraindications.
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What to do
by Jan 1, 2025 · 7 steps
01Billing team must implement the following changes in the billing system.
02Remove HCPCS code J9010 (Erwinaze) from all claim submission rules and block any claims attempting to bill this code—these claims will be denied as the drug is no longer manufactured.
03Ensure HCPCS code J9021 (Rylaze) is correctly configured as the active replacement code for asparaginase erwinia chrysanthemi recombinant therapy.
04Update prior authorization templates and clinical decision support to reflect the medical necessity criteria: multi-agent chemotherapy use, documented hypersensitivity to E.
05coli-derived asparaginase (calaspargase pegol-mknl or pegaspargase), and absence of contraindications (prior severe hypersensitivity to Rylaze, prior serious pancreatitis, prior serious hemorrhagic/thrombotic events, or severe hepatic impairment).
06Oncology providers and prior authorization staff must be notified of this change.
07Claims for J9010 submitted after the effective date will be denied; claims for J9021 require documentation of medical necessity criteria to avoid denial.
Codes mentioned
J9010J9021
Original notice
08.01.35i, Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
See all Independence Blue Cross changes →MA08.085i, Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)MediumEffective Jan 1, 2025 · PharmacyMA08.085j, Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)MediumEffective Aug 25, 2025 · PharmacyMA08.085k, Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)LowEffective Jan 1, 2026 · PharmacyMA08.085k, Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)MediumEffective Jan 1, 2026 · PharmacyBrowse every Independence Blue Cross change in the policy list