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MA11.007b, Islet Cell Transplantation, including use of Donislecel-jujn (Lantidra)
Act
by Feb 26, 2024 (or upon first encounter after this date)
Effective date
Feb 26, 2024
Identified
Jun 19, 2026
Summary
Independence Blue Cross Medicare Advantage reissued policy MA11.007b on the coverage of islet cell transplantation, adding donislecel-jujn (Lantidra) as experimental/investigational. Autologous islet cell transplantation remains covered only as an adjunct to total or near-total pancreatectomy for chronic pancreatitis; allogeneic islet cell transplantation and Lantidra are not covered. Three new HCPCS codes (C9399, J3490, J3590) representing Lantidra have been added to the policy.
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What to do
by Feb 26, 2024 (or upon first encounter after this date) · 5 steps
01Billing team must update billing system to deny all claims for allogeneic islet cell transplantation, including any claims using HCPCS codes C9399, J3490, or J3590 for donislecel-jujn (Lantidra) under Medicare Advantage plans.
02Configure system to deny S2102 (allogeneic islet cell tissue transplant) claims.
03Verify that claims for autologous islet cell transplantation (CPT 0584T, 0585T, 0586T, 48160 and HCPCS G0341, G0342, G0343) continue to process only when accompanied by documented chronic pancreatitis diagnosis (K86.0 or K86.1) and adjunct to pancreatectomy.
04Communicate to providers that Lantidra is experimental/investigational and not covered under this MA plan.
05All claims for non-covered services will be denied without exception.
Codes mentioned
48160G0341G0342G0343S2102C9399J3490J3590K86.0K86.1Z90.410Z90.411
Original notice
MA11.007b, Islet Cell Transplantation, including use of Donislecel-jujn (Lantidra)
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
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