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CommercialPrior AuthMedium impact

Placental and Umbilical Cord Blood as a Source of Stem Cells

Blue Cross & Blue Shield of Mississippi·MS · Hematology, Oncology, OB-GYN·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

Blue Cross Blue Shield of Mississippi updated their policy on placental and umbilical cord blood stem cell transplantation, requiring prior authorization through case management for all covered transplant procedures and evaluations. The policy clarifies that cord blood stem cell transplantation is medically necessary only for appropriate allogeneic transplant indications, while prophylactic collection and storage is considered not medically necessary.

Action Required

Action needed
Immediately: Billing team must ensure prior authorization is obtained through BCBS Mississippi case management before scheduling any cord blood stem cell transplant procedures or evaluations. Update system to flag these procedures for prior auth requirements. Claims will be denied without proper authorization.

Affected Billing Codes

86812
86813
86816
86817
86821
86822