CommercialPrior AuthLow impact
Isolated Small Bowel Transplant
Blue Cross & Blue Shield of Mississippi·MS · Gastroenterology, General Surgery, Pediatrics +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
Blue Cross & Blue Shield of Mississippi has updated their policy for isolated small bowel transplants, establishing specific medical necessity criteria and requiring prior authorization through case management for all covered transplant procedures. The policy covers cadaveric and living donor transplants only for patients with severe TPN complications.
Action Required
Immediately: Billing team must ensure prior authorization is obtained through Blue Cross & Blue Shield of Mississippi case management before scheduling any small bowel transplant procedures. Update pre-authorization checklists to include documentation of intestinal failure, TPN dependency, and severe TPN complications. Claims will not be covered without prior authorization.