CLV IntelligenceReimbursement Policy Monitoring

Code intelligence

I13 reimbursement alerts

Policy changes, MAC LCD updates, and CMS guidance matched to code I13.

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No policy changes are currently matched to I13

CMS, MAC, and Federal Register sources are monitored daily. When a policy change is matched to this code, it will appear here automatically.

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Latest reimbursement alerts

The most recent policy changes across all codes and specialties.

CMS Transmittal R13945MPI: Updates to Chapter 3, Chapter 4, and Chapter 5 in Publication (Pub.) 100-15, Including Updates…

CMS-T-R13945MPI · Medicaid

High

Pub. 100-15 Medicaid chapters updated; review by Oct 5, 2026.

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FDA Approval: RASONQUE (DARAXONRASIB) — Type 1 - New Molecular Entity

FDA-NDA220910 · Oncology

Routine

Oral orphan NME daraxonrasib routes to Part D; no J-code applies.

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FDA Approval: VOBRIG (LEUPROLIDE ACETATE) — Type 5 - New Formulation or New Manufacturer

FDA-NDA213225 · Oncology

Routine

New leuprolide injectable; verify J-code before billing under Part B.

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FDA Approval: NDA 220106 — Type 1 - New Molecular Entity

FDA-NDA220106 · Multi-specialty

Routine

Orphan NME approved; billing pathway unknown pending FDA label.

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FDA Approval: BIXLENVO (BICTEGRAVIR/LENACAPAVIR) — Type 4 - New Combination

FDA-NDA221104 · Infectious Disease

Low

Oral HIV combo BIXLENVO routes through Part D; no J-code needed.

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FDA Approval: NDA 221443 — Type 4 - New Combination

FDA-NDA221443 · Multi-specialty

Low

Gilead combo drug approved; billing pathway pending FDA label.

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FDA Approval: MIMRYLO (RUSFERTIDE ACETATE) — Type 1 - New Molecular Entity

FDA-NDA220605 · Hematology

Routine

Orphan NME approved; billing pathway TBD pending FDA label.

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FDA Approval: UNLOXCYT (COSIBELIMAB) — Type 1 - New Molecular Entity

FDA-BLA761297 · Oncology

High

New PD-L1 inhibitor Unloxcyt approved; Part B injectable, no J-code yet.

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Audit documentation

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The Tripwire Audit Pack exports 12 months of single-specialty policy-change history — every alert with a link to its government source document, as a formatted PDF for compliance distribution plus a machine-readable CSV. Delivered automatically after payment. No account, no call.

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