Summary
BCBS Mississippi has added a new policy stating that Kimyrsa (oritavancin) injections are considered not medically necessary for treating bacterial skin infections, as other covered alternatives are available. Prior authorization is required, and services will be denied without BCBSMS PA approval.
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What to do
immediately · 4 steps
01Stop billing J2406 (Kimyrsa injections) for BCBS Mississippi patients without prior authorization.
02Update billing system to flag this code for PA requirement.
03Inform providers that alternative covered antibiotics should be used for bacterial skin infections.
04Claims for J2406 without BCBSMS PA approval will be denied as not medically necessary.
Codes mentioned
J2406
Original notice
Kimyrsa (oritavancin)
bcbsms.com · Always check the source before changing claims.