Medicare AdvantageAdministrativeLow impact
MA08.168, Elranatamab-bcmm (Elrexfio™)
Independence Blue Cross·Oncology, Hematology, Pharmacy·Pharmacy
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued Medicare Advantage policy MA08.168 on April 2, 2025, as part of its annual review process. The policy covers elranatamab-bcmm (Elrexfio) for refractory or relapsed multiple myeloma in adults with at least four prior therapies meeting specific criteria. No substantive coverage changes were made in this reissue; the policy maintains the same medical necessity criteria, documentation requirements, and billing codes from the original April 22, 2024 version.
Action Required
No immediate action required. This is an administrative reissuance with no coverage criteria changes. Billing team should retain the current policy documentation for MA08.168a (superseding MA08.168) in their reference files. Verify that HCPCS code J1323 continues to be billed with appropriate ICD-10 diagnosis codes and that prior authorization procedures (if any) remain in place for claims submitted under this policy. No system updates or workflow changes are needed.