CommercialCoverageMedium impact
Kimyrsa (oritavancin)
Blue Cross & Blue Shield of Mississippi·MS · Infectious Disease, Dermatology, Emergency Medicine +2 more·Medical Policy
Effective date
Nov 1, 2025
We identified it
Jun 20, 2026
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.
Action Required
Immediately: Stop billing J2406 (Kimyrsa injections) for BCBS Mississippi patients without prior authorization. Update billing system to flag this code for PA requirement. Inform providers that alternative covered antibiotics should be used for bacterial skin infections. Claims for J2406 without BCBSMS PA approval will be denied as not medically necessary.