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Independence Blue CrossMedicare Advantage · Administrative · Pharmacy · Gastroenterology, Hematology, Allergy & Immunology +1 moreLow impact

MA08.167, Pozelimab-bbfg (Veopoz®)

Effective date
Not stated in the notice
Identified
Jun 19, 2026

Summary

Independence Blue Cross reissued MA08.167 on 05/27/2026 with no substantive changes to pozelimab-bbfg (Veopoz®) coverage criteria for CHAPLE disease. This is a status reissue confirming the company's continuing position on the policy; billing teams should verify local system records reflect the current reissue date but no workflow changes are required.

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What to do

Action · 4 steps
01No immediate action required.
02Billing team should verify that system records reflect the most recent reissue date of 05/27/2026 for audit and compliance purposes.
03Confirm that prior authorizations for pozelimab-bbfg (Veopoz®) continue to require documentation of: (1) biallelic CD55 loss-of-function mutation confirmation, (2) presence of qualifying symptoms within last 6 months, (3) meningococcal vaccination completion at least 2 weeks prior, (4) specialist ordering (Gastroenterology, Hematology, Immunology, or rare genetic hematologic disease specialist), (5) no concurrent complement inhibitors, and (6) no active Neisseria meningitidis infection.
04Claims will be denied without full medical necessity documentation.

Codes mentioned

J9376D84.1K90.49

Original notice

MA08.167, Pozelimab-bbfg (Veopoz®)
medpolicy.ibx.com · Always check the source before changing claims.
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Related policy hubs

Independence Blue Cross policiesGastroenterologyHematologyAllergy & ImmunologyGeneticsCode J9376Code D84.1Code K90.49

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