CommercialCoverageMedium impact
Radiofrequency Ablation of Primary or Metastatic Liver Tumors
Blue Cross & Blue Shield of Mississippi·MS · Gastroenterology, Oncology, General Surgery +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield Mississippi updated their radiofrequency ablation policy for liver tumors, establishing clear criteria for when RFA is considered medically necessary versus investigational. The policy defines specific Milan criteria (single tumor ≤5cm or up to 3 nodules <3cm) for coverage of hepatocellular carcinoma and colorectal/neuroendocrine metastases.
Action Required
Immediately: Review all pending and future radiofrequency ablation claims for liver tumors to ensure they meet the Milan criteria (single tumor ≤5cm or up to 3 nodules <3cm) for hepatocellular carcinoma, colorectal metastases, or neuroendocrine metastases with failed systemic therapy. Update prior authorization requests to document tumor size, number, and origin. Claims not meeting these specific criteria will be considered investigational and likely denied.