Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
Blue Cross & Blue Shield of MississippiAll Plans · Coverage · Medical Policy · Cardiology, Cardiothoracic SurgeryMedium impact

Transcatheter Tricuspid Valve Repair or Replacement

Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

Transcatheter tricuspid edge-to-edge repair (T-TEER) with an FDA-approved device may be considered medically necessary for severe tricuspid regurgitation despite maximally tolerated guideline-directed medical therapy in individuals a heart team assesses as intermediate or high risk for open surgery. Transcatheter tricuspid valve replacement (TTVR) with an FDA-approved device may be considered medically necessary for severe tricuspid regurgitation despite maximally tolerated guideline-directed medical therapy in individuals a heart team identifies as TTVR candidates. T-TEER and TTVR are considered investigational in all other situations.

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.

Get Blue Cross & Blue Shield of Mississippi alertsPolicy Monitoring is free. No card required.

What to do

Action · 6 steps
01Check current applicability before acting on this policy.
02Billing team: before billing CPT 0569T or 0570T for T-TEER, document severe tricuspid regurgitation despite maximally tolerated guideline-directed medical therapy and a heart team assessment of intermediate or high risk for open surgery.
03The policy defines intermediate risk as an STS predicted mortality risk of 3% to 7%, and high risk as an STS predicted operative risk score of 8% or higher or a heart team judgment of expected mortality of 15% or higher for open surgery.
04Before billing CPT 0646T for TTVR, document the heart team identification of the patient as a TTVR candidate.
05The heart team should include a cardiac surgeon, an interventional cardiologist, a cardiologist with heart failure training, an electrophysiologic specialist, a multi-modality imaging specialist and an interventional echocardiographer.
06BCBSMS makes no payment for services not documented to be Medically Necessary.

Codes mentioned

I07.0I07.1I07.2I07.8I07.9I36.0I36.1I36.2I36.8I36.9

Original notice

Transcatheter Tricuspid Valve Repair or Replacement
bcbsms.com · Always check the source before changing claims.
View original ↗

Related policy hubs

Blue Cross & Blue Shield of Mississippi policiesCardiologyCardiothoracic SurgeryCode I07.0Code I07.1Code I07.2Code I07.8Code I07.9Code I36.0Code I36.1Code I36.2Code I36.8Code I36.9

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.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account