CommercialCoverageMedium impact
Hip Resurfacing
Blue Cross & Blue Shield of Mississippi·MS · Orthopedics·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their hip resurfacing policy (A.7.01.80) defining medical necessity criteria for metal-on-metal total hip resurfacing and partial hip resurfacing with FDA-approved devices. The policy establishes specific contraindications and requires patients to be candidates for total hip replacement who are likely to outlive traditional prostheses.
Action Required
Immediately: Review hip resurfacing claims to ensure they meet new medical necessity criteria. Verify patients are candidates for total hip replacement, likely to outlive traditional prostheses, and don't have listed contraindications (severe osteopenia, >50% femoral head involvement, metal sensitivity, renal insufficiency, etc.). Update prior authorization requests to include documentation of medical necessity per policy A.7.01.80. All non-FDA approved hip resurfacing procedures will be denied as investigational.