Blue Cross & Blue Shield of MississippiAll Plans · Coverage · Medical Policy · Oncology, Urology, PulmonologyMedium impact
Cryoablation of Tumors Located in the Kidney, Lung, Breast, Pancreas, or Bone
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Cryosurgical ablation may be considered medically necessary to treat localized renal cell carcinoma no more than 4 cm in size when kidney function preservation is necessary or the individual is not a surgical candidate, and to treat lung cancer in an individual with early-stage non-small-cell lung cancer who is a poor surgical candidate or who requires palliation of a central airway obstructing lesion. It is considered investigational for benign or malignant tumors of the breast, lung other than as defined above, pancreas, or bone, and for renal cell carcinoma in individuals who are surgical candidates. The policy history records a 09/12/2025 review with no changes.
Get alerts when payers change rules like this one
We check Blue Cross & Blue Shield of Mississippi and other payers every day and email you when a change matches your specialty and state.
01Billing team: Renal cell carcinoma ablation may be considered medically necessary only when the individual has one kidney or renal insufficiency defined by a glomerular filtration rate of less than 60 mL/min per m2 and standard surgical resection is likely to worsen kidney function substantially, or when the individual is not considered a surgical candidate.
02Lung cancer ablation may be considered medically necessary only when the individual has early-stage non-small-cell lung cancer and is a poor surgical candidate, or requires palliation for a central airway obstructing lesion.
03Ablation of breast tumors (code 0581T), fibroadenoma (code 19105), and bone tumors (code 20983) is investigational.
04This policy does not address pediatric indications.
05BCBSMS makes no payment for services that are not documented to be Medically Necessary.
Summaries are AI-assisted. Always confirm against the original payer notice.
What is PolicyChanges
One workspace for payer rules, prior auth, coding and compliance
Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.