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Nonmyeloablative Allogeneic Transplants of Hematopoietic Stem-Cells for Treatment of Malignancy

Blue Cross & Blue Shield of Mississippi·MS · Oncology, Hematology·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 nonmyeloablative allogeneic stem cell transplants for cancer treatment. The policy requires prior authorization through Case Management for all covered transplant procedures and evaluations, and specifies that the procedure is only medically necessary for patients who would otherwise meet criteria for high-dose chemotherapy and allogeneic stem cell transplantation.

Action Required

Action needed
Immediately: Billing team must ensure prior authorization through Case Management is obtained from BCBS Mississippi before scheduling or billing for any nonmyeloablative allogeneic stem cell transplant procedures or evaluations. Update billing system to flag these procedures for mandatory prior auth. Claims will be denied without prior authorization.

Affected Billing Codes

38230
38240
86812
86813
86816
86817
86821
86822
86825
86826
G0355
G0356
G0357
G0358
G0359
G0360
G0361
G0362
G0363
G0364
S2140
S2142