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Alpha-1 Proteinase Inhibitors

Blue Cross & Blue Shield of Mississippi·MS · Pulmonology, Internal Medicine·Medical Policy
Effective date
Feb 24, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

Blue Cross Blue Shield of Mississippi updated their prior authorization policy for Alpha-1 Proteinase Inhibitors (Aralast NP, Glassia, Prolastin-C, Zemaira). Key changes include stricter age requirements (18+ only), updated baseline FEV1 criteria, and clarification that drug samples cannot be used to satisfy policy requirements.

Action Required

Action needed
By February 24, 2026: Billing team must update prior authorization processes for Alpha-1 Proteinase Inhibitors to reflect new age requirement (18+ only), updated FEV1 baseline criteria, and ensure drug samples are not counted as current therapy. Pulmonology and other relevant providers should be notified of the stricter documentation requirements for initial and renewal approvals.

Affected Billing Codes

E88.01