CommercialCoverageLow impact
Transmyocardial Revascularization
Blue Cross & Blue Shield of Mississippi·MS · Cardiology, Cardiothoracic Surgery·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their Transmyocardial Revascularization policy defining specific coverage criteria for TMR procedures. The policy covers TMR for class III/IV angina patients not eligible for CABG/PTCA who meet strict medical criteria, but considers percutaneous TMR investigational.
Action Required
Billing team should review TMR claims to ensure they meet the specific medical necessity criteria: class III/IV angina refractory to medical management, documented reversible ischemia, left ventricular ejection fraction >30%, no recent MI/unstable angina within 21 days, and no severe COPD. Note that CPT 33141 is covered when used as adjunct to CABG but not separately billable, while percutaneous TMR remains investigational.