CommercialCoverageLow impact
Lipid Apheresis
Blue Cross & Blue Shield of Mississippi·MS · Cardiology, Endocrinology, Nephrology·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their Lipid Apheresis policy defining coverage criteria for LDL apheresis procedures. The policy specifies that LDL apheresis is medically necessary for homozygous familial hypercholesterolemia and heterozygous familial hypercholesterolemia patients meeting specific LDL levels and treatment failure criteria, while HDL delipidation remains investigational.
Action Required
Review current lipid apheresis claims to ensure they meet the new coverage criteria: homozygous FH patients or heterozygous FH patients with LDL ≥300 mg/dL (or ≥200 mg/dL with documented CAD) who have failed maximum tolerated drug therapy. Verify documentation includes evidence of failed diet therapy and combination drug therapy before approving claims.