CommercialBilling CodesMedium impact
Daptomycin
Blue Cross & Blue Shield of Mississippi·MS · Infectious Disease, Internal Medicine, Family Medicine +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their daptomycin (Cubicin) policy with revised age criteria for bloodstream infections and added new HCPCS billing codes. The policy now specifies that patients 18+ (instead of adults generally) with S. aureus bacteremia including right-sided endocarditis are covered, and added four new manufacturer-specific HCPCS codes for different daptomycin formulations.
Action Required
Immediately: Update billing system to include new HCPCS codes J0872, J0873, J0874, and J0877 for different daptomycin manufacturers. Ensure prior authorization process verifies patient age 18+ for S. aureus bacteremia cases (previously just 'adults'). Add new ICD-10 codes L02.217, L02.227, L03.31A, and L03.32A to covered diagnosis list. Verify infectious disease specialist consultation requirement is documented for all daptomycin prior authorizations.