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Blue Cross & Blue Shield of MississippiCommercial · Prior Auth · Medical Policy · MS · Transplant Surgery, Endocrinology, GastroenterologyMedium impact

Islet Transplantation for Chronic Pancreatitis and Donislecel-jujn for Type 1 Diabetes

Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

Prior authorization through Case Management from Blue Cross & Blue Shield of Mississippi is required for a covered transplant procedure or transplant evaluation, and no benefits are provided without it. Autologous islet transplantation may be considered medically necessary as an adjunct to a total or near total pancreatectomy in individuals with chronic pancreatitis. Allogeneic islet transplantation using donislecel-jujn (Lantidra) is considered investigational for type 1 diabetes, and islet transplantation with donislecel-jujn is considered investigational in all other situations.

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What to do

Action · 8 steps
01Requirements: Obtain prior authorization through Case Management from Blue Cross & Blue Shield of Mississippi for any covered transplant procedure or transplant evaluation.
02No benefits are provided without it.
03Autologous islet transplantation with total or near total pancreatectomy for chronic pancreatitis may be medically necessary, and it may require referral to an out of network facility.
04CPT 48160 is listed as covered and is medically necessary only when the procedure is performed according to the policy section.
05Allogeneic islet transplantation with donislecel-jujn (Lantidra) is investigational for type 1 diabetes.
06Islet transplantation with donislecel-jujn is investigational in all other situations.
07Repeated intraportal islet infusions are not recommended in patients who have had prior portal thrombosis, unless the thrombosis was limited to second- or third-order portal vein branches.
08There is no evidence to support donislecel-jujn for individuals with liver disease, renal failure, or who have received a renal transplant.

Codes mentioned

48160G0341G0342G0343S2102K86.1

Original notice

Islet Transplantation for Chronic Pancreatitis and Donislecel-jujn for Type 1 Diabetes
bcbsms.com · Always check the source before changing claims.
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Related policy hubs

Blue Cross & Blue Shield of Mississippi policiesMS policy changesTransplant SurgeryEndocrinologyGastroenterologyCode 48160Code G0341Code G0342Code G0343Code S2102Code K86.1

Summaries are AI-assisted. Always confirm against the original payer notice.

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