All PlansCoverageMedium impact
Small Bowel and Multivisceral Transplants in Adults and Children 7.02.05
Excellus BlueCross BlueShield·Gastroenterology, General Surgery, Critical Care +1 more·Transplants
Effective date
Mar 19, 2026
We identified it
Jun 20, 2026
Summary
New policy 7.02.05 establishes coverage criteria for small bowel and multivisceral transplants in adults and children. Small bowel transplants are covered for patients with short bowel syndrome meeting specific complications criteria, while multivisceral transplants are covered for patients with concurrent intestinal and liver failure.
Action Required
Before March 19, 2026: Billing team must review transplant cases to ensure documentation meets new criteria including adequate cardiopulmonary status, absence of active infection, compliance documentation, and specific indications for small bowel or multivisceral transplants. Update prior authorization workflows to include comprehensive pre-transplant evaluation requirements including clinical, psychosocial, performance status, and age-appropriate screening documentation.