All PlansCoverageMedium impact
Transcatheter Mitral Valve Repair or Replacement
Blue Cross & Blue Shield of Mississippi·MS · Cardiology, Cardiothoracic Surgery·Medical Policy
We identified it
Jun 20, 2026
Summary
New policy defines coverage criteria for transcatheter mitral valve repair and replacement procedures, including MitraClip, PASCAL, and Edwards SAPIEN 3 devices for treating mitral regurgitation in high-risk surgical patients. This establishes medical necessity requirements for these minimally invasive cardiac procedures.
Action Required
Immediately: Review policy A.2.02.30 for transcatheter mitral valve procedures. Billing team and providers should familiarize themselves with covered devices (MitraClip, PASCAL, Edwards SAPIEN 3) and patient eligibility criteria including prohibitive surgical risk requirements. Ensure documentation supports medical necessity for high-risk patients with severe symptomatic mitral regurgitation before submitting claims.