← Back to list
MA08.085j, Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)
Act
by Aug 25, 2025
Effective date
Aug 25, 2025
Identified
Jun 19, 2026
Summary
Independence Blue Cross updated Medicare Advantage policy MA08.085j to MA08.085k, revising coverage criteria for Rylaze (asparaginase erwinia chrysanthemi recombinant-rywn) effective 08/25/2025 in accordance with updated FDA labeling and NCCN guidelines. The policy now covers this drug for acute lymphoblastic leukemia, lymphoblastic lymphoma, and extranodal NK/T-cell lymphomas in eligible patients with E. coli-derived asparaginase hypersensitivity. All ICD-10 codes were removed from the policy, requiring providers to report the most appropriate diagnosis code supporting medical necessity.
Get alerts when payers change rules like this one
We check Independence Blue Cross and other payers every day and email you when a change matches your specialty and state.
Get Independence Blue Cross alertsPolicy Monitoring is free. No card required.
What to do
by Aug 25, 2025 · 6 steps
01Billing team must update authorization and claims submission procedures for HCPCS code J9021 (Rylaze injection).
02When processing claims, verify that all medically necessary criteria are documented and met: (1) use as component of multi-agent chemotherapy regimen, (2) documented hypersensitivity to E.
03coli-derived asparaginase, and (3) absence of contraindications (serious prior hypersensitivity reactions, pancreatitis, hemorrhage/thrombosis events, or severe hepatic impairment).
04Update system to require appropriate ICD-10 diagnosis codes (ALL, lymphoblastic lymphoma, or extranodal NK/T-cell lymphoma) with all J9021 claims, as ICD-10 codes are no longer listed in the policy.
05Communicate to providers that asparaginase erwinia chrysanthemi (Erwinaze) is no longer reimbursable as it was removed from the market in 2021—only Rylaze (J9021) is covered.
06Claims submitted without proper medical necessity documentation or for ineligible diagnoses will be denied.
Codes mentioned
J9021
Original notice
MA08.085j, 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 · PharmacyMA08.085k, Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)LowEffective Jan 1, 2026 · PharmacyMA08.085k, Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)MediumEffective Jan 1, 2026 · Pharmacy08.01.35i, Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)MediumEffective Jan 1, 2025 · PharmacyBrowse every Independence Blue Cross change in the policy list