Provider Alert! Clinical Criteria for Xenpozyme Procedure Code J0218 effective May 1, 2023
Date: April 6, 2023 Attention: All Providers Effective Date: May 1, 2023 Call to action: Effective May 1, 2023, the Health and Human Services Commission (HHSC) will begin the incorporation of prior authorization criteria for Xenpozyme (procedure code J0218) to the Enzyme Replacement Therapy policy. Xenpozyme is the first therapy indicated specifically for the treatment of non-central nervous system manifestations of acid sphingomyelinase deficiency (ASMD) in adult and pediatric patients, and is currently the only approved treatment for this disease. Authorization Requirements 1. Member has...
