Medicare AdvantageBilling CodesMedium impact
MA08.023d, Enzyme Replacement for the Treatment of Gaucher's Disease
Independence Blue Cross·Genetics, Pediatrics, Internal Medicine +1 more·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross Medicare Advantage policy MA08.023d removed HCPCS code J0205 (alglucerase injection) effective 01/01/2026 because alglucerase is no longer manufactured and has been withdrawn from market. Billing teams must stop billing this code and ensure claims use only the three covered enzyme replacement therapy codes: J1786, J3060, or J3385.
Action Required
By January 1, 2026: Billing team must remove HCPCS code J0205 (alglucerase) from all billing systems, fee schedules, and encounter templates for Independence Blue Cross Medicare Advantage plans. Update claim submission logic to reject or flag any claims using J0205. Notify providers and clinical staff that J0205 is no longer eligible for reimbursement due to market withdrawal of alglucerase (Ceredase®). All Gaucher's disease enzyme replacement therapy claims must use only J1786 (imiglucerase), J3060 (taliglucerase alfa), or J3385 (velaglucerase alfa). Claims submitted with J0205 will be denied or require correction before payment.