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CommercialCoverageMedium impact

Prostatic Urethral Lift

Blue Cross & Blue Shield of Mississippi·MS · Urology·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

BCBS Mississippi updated their prostatic urethral lift policy defining specific criteria for medical necessity coverage. The policy establishes clear requirements including failed 6-month medical therapy, prostate size ≤80 mL, specific anatomical criteria, and excludes repeat procedures as investigational.

Action Required

Action needed
Immediately: Billing team must verify all prostatic urethral lift claims meet the six specific criteria before submission: 6-month failed medical therapy or intolerance, prostate ≤80 mL, normal bladder neck anatomy, exclude other urinary retention causes, prostate cancer screening completed, and no nickel/titanium/steel allergies documented. Flag repeat procedures as non-covered investigational. Update prior authorization checklists to include these requirements.