23 commercial payer policies list J0217. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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23 policies from 15 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
Codes labeled “Inferred from policy title” are not listed in the policy document; Backwork attached them because the policy title names the drug.
| Policy | Effective | Status of J0217 |
|---|---|---|
| Lamzede (velmanase alfa-tycv intravenous infusion)Effective 08/01/2024 - 06/30/2025 | Aug 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Lamzede (velmanase alfa-tycv) | Not recorded | Prior auth requiredInferred from policy title |
| Lamzede (velmanase alfa-tycv)Effective 07/01/2025 - 06/30/2026 | Jul 1, 2025 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Lamzede (velmanase alfa-tycv)Effective 08/01/2023 - 07/31/2024 | Aug 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Policy | Effective | Status of J0217 |
|---|---|---|
| Velmanase alfa (Lamzede) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Velmanase alfa (Lamzede) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0217 |
|---|---|---|
| Velmanase alfa (Lamzede) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Velmanase alfa (Lamzede) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0217 |
|---|---|---|
| Lamzede (velmanase alfa-tycv) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Lamzede (velmanase alfa-tycv) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0217 |
|---|---|---|
| Medical Therapies for Enzyme Deficiencies | Oct 1, 2026 | Covered |
| Provider Administered Drugs – Site of Care | Oct 1, 2026 | Covered |
| Policy | Effective | Status of J0217 |
|---|---|---|
| Medical Therapies for Enzyme Deficiencies | Oct 1, 2026 | Covered |
| Provider Administered Drugs – Site of Care | Oct 1, 2026 | Covered |
| Policy | Effective | Status of J0217 |
|---|---|---|
| Velmanase alfa-tycv (e.g., Lamzede) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0217 |
|---|---|---|
| LAMZEDE (VELMANASE ALFA-TYCV) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0217 |
|---|---|---|
| Velmanase Alfa-tycv (Lamzede) | May 31, 2023 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0217 |
|---|---|---|
| Velmanase Alfa-tycv (Lamzede); CP.PHAR.601 | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0217 |
|---|---|---|
| Velmanase alfa-tycv (Lamzede) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0217 |
|---|---|---|
| 00849 velmanase alfa-tycv (Lamzede) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0217 |
|---|---|---|
| Lamzede (velmanase alfa-tycv) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0217 |
|---|---|---|
| Lamzede (velmanase alfa-tycv) (PG146, Ver. 3) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0217 |
|---|---|---|
| Medical Therapies for Enzyme Deficiencies | Oct 1, 2026 | Covered |