Back to dashboard
CommercialBilling CodesMedium impact

Pyrocarbon Metacarpophalangeal and Proximal Interphalangeal Joint Implants

Blue Cross & Blue Shield of Mississippi·MS · Orthopedics, Plastic Surgery·Medical Policy
Effective date
Oct 1, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Blue Cross Blue Shield Mississippi updated their policy on pyrocarbon joint implants for hand joints, maintaining that these devices are considered investigational and not covered. New HCPCS codes L6035 and L6036 were added effective 10/01/2025 for prosthetic digits and thumbs.

Action Required

Action needed
By October 1, 2025: Billing team must update system to include new HCPCS codes L6035 and L6036 for prosthetic digits and thumbs. Mark all listed codes as investigational/non-covered for BCBS Mississippi members. Verify prior authorization requirements before scheduling procedures involving pyrocarbon joint implants as these remain non-covered.

Affected Billing Codes

26531
26536
L6035
L6036
L8630
L8631
L8658
L8659