Medicare AdvantageCoverageMedium impact
MA08.158c, Mosunetuzumab-axgb (Lunsumio™)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Jun 16, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.158c for Mosunetuzumab-axgb (Lunsumio™) has been updated with changes to medical necessity criteria and medical coding requirements. This affects billing and coverage determination for this specialty oncology medication used in lymphoma treatment.
Action Required
By June 16, 2025: Billing and clinical teams must review updated medical necessity criteria for Mosunetuzumab-axgb (Lunsumio™) coverage. Update prior authorization documentation requirements and ensure proper medical coding compliance per the revised policy. Oncology providers should verify documentation meets new criteria before submitting claims.