MA08.159c, Mirvetuximab soravtansine-gynx (Elahere®)

By 06/16/2025 (immediately if after this date): Billing team must review and implement MA08.159c medical necessity criteria for Mirvetuximab soravtansine-gynx (Elahere®) claims. Obtain the full policy text from the provided URL to identify specific coding requirements and documentation needs. Ensure all claims for this drug include required medical necessity supporting documentation per the new criteria. Update billing software rules and claim submission templates to enforce these requirements. Providers must document medical necessity elements before billing. Claims submitted without proper medical necessity documentation will be denied by Medicare Advantage plans.