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Independence Blue CrossMedicare Advantage · Administrative · Medical Policy · Genetics, Pediatrics, PharmacyLow impact

MA08.147, Velmanase alfa (Lamzede)

Effective date
Not stated in the notice
Identified
Jun 19, 2026

Summary

Independence Blue Cross reissued MA08.147 on 05/28/2025 with no substantive changes to communicate the company's continuing coverage position for velmanase alfa-tycv (Lamzede) for non-CNS manifestations of alpha-mannosidosis in pediatric and adult patients age 3+. The policy remains unchanged from its original 03/11/2024 effective date, including all coverage criteria, continuation requirements, and dosing specifications.

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What to do

Action · 5 steps
01No immediate action required.
02This is a reissue with no changes to the policy content.
03Billing teams should note the 05/28/2025 review date for audit purposes, but all prior authorization and billing procedures for velmanase alfa-tycv (Lamzede) remain unchanged.
04Continue to apply existing coverage criteria: require diagnosis confirmation via biochemical assay or MAN2B1 genotyping, documented baseline motor/pulmonary function testing, patient age minimum 3 years, and specialist prescription.
05No HSCT history and ability to walk without support remain requirements.

Codes mentioned

J0217E77.1

Original notice

MA08.147, Velmanase alfa (Lamzede)
medpolicy.ibx.com · Always check the source before changing claims.
View original ↗

Related changes

See all Independence Blue Cross changes →
08.02.04, Velmanase alfa (Lamzede)LowEffective Mar 11, 2024 · Medical PolicyBrowse every Independence Blue Cross change in the policy list

Related policy hubs

Independence Blue Cross policiesGeneticsPediatricsPharmacyCode J0217Code E77.1

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