CommercialCoverageLow impact
Korsuva (difelikefalin)
Blue Cross & Blue Shield of Mississippi·MS · Nephrology·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi has updated their policy for Korsuva (difelikefalin), maintaining that it is considered not medically necessary for treating pruritus in chronic kidney disease patients on hemodialysis. The policy was recently reviewed by their Pharmacy & Therapeutics Committee with no changes to coverage determination.
Action Required
Immediately: Ensure billing staff are aware that HCPCS code J0879 (injection, difelikefalin, 0.1 mcg) will be denied as not medically necessary for BCBS Mississippi patients. Do not submit claims for Korsuva administration without prior authorization approval through BCBSMS PA review process. Claims will be denied without proper authorization.