CommercialCoverageMedium impact
Corneal Collagen Cross-Linking
Blue Cross & Blue Shield of Mississippi·MS · Ophthalmology·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi has established a new medical policy for corneal collagen cross-linking, covering this FDA-approved procedure for progressive keratoconus and corneal ectasia after refractive surgery when conservative treatments have failed. The policy defines specific progression criteria and declares the procedure medically necessary under these conditions, while considering it investigational for all other uses.
Action Required
Immediately: Billing team should review claims for corneal collagen cross-linking procedures to ensure documentation shows progressive keratoconus or corneal ectasia with failed conservative treatment (spectacles, rigid contact lenses). Update prior authorization workflows to capture progression criteria: ≥1 diopter increase in steepest keratometry, ≥1 diopter increase in regular astigmatism, ≥0.50 diopter myopic shift, or ≥0.1mm decrease in back optical zone radius. Claims for other indications will be denied as investigational.