Medicare AdvantageCoverageMedium impact
MA11.007b, Islet Cell Transplantation, including use of Donislecel-jujn (Lantidra)
Independence Blue Cross·Transplant Surgery, Endocrinology·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
Policy MA11.007b has been reissued effective April 1, 2026, addressing islet cell transplantation coverage and the use of Donislecel-jujn (Lantidra). This is a recent policy update that establishes or clarifies coverage guidelines for this specialized transplant procedure and its associated immunosuppressive therapy. Billing teams must review the full policy text to identify any changes to prior authorization requirements, covered indications, or billing procedures.
Action Required
By March 15, 2026: Billing and clinical teams must obtain and review the complete MA11.007b policy text from the provided URL to identify: (1) specific CPT/HCPCS codes for islet cell transplantation procedures, (2) prior authorization requirements, (3) coverage criteria and medical necessity documentation requirements, and (4) any changes from the previous policy version. Update billing system rules, prior authorization protocols, and provider documentation templates accordingly. Coordinate with transplant surgery and endocrinology departments to ensure providers understand new requirements before the April 1, 2026 effective date. Claims submitted without compliance may be denied.