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Hematopoietic Cell Transplantation for Acute Myeloid Leukemia
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
A 07/24/2026 review revised the policy statement on allogeneic HCT using a reduced-intensity conditioning regimen to remove the reference to Policy Guidelines, and the Code Reference section was updated to remove ICD-9 procedure and diagnosis codes. Allogeneic HCT with myeloablative conditioning may be considered medically necessary for poor- to intermediate-risk AML in first complete remission and for certain refractory or relapsed AML, while autologous HCT may be considered for AML in CR1 or beyond, or relapsed AML, in individuals who are not candidates for allogeneic HCT.
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What to do
Action · 5 steps
01Check current applicability of the 07/24/2026 change before billing these services.
02Billing team: get prior authorization through Case Management from Blue Cross & Blue Shield of Mississippi before any covered transplant procedure, because no benefits will be provided without it.
03For allogeneic HCT with a reduced-intensity conditioning regimen, confirm the member is in complete marrow and extramedullary remission (CR1 or beyond) and cannot medically tolerate a myeloablative regimen.
04For State and School Employee subscribers, the Plan's Utilization Review Vendor must certify that all transplants are medically necessary, and no benefits will be provided without prior approval.
05Allogeneic and autologous HCT for individuals not meeting the listed criteria is considered investigational.
Codes mentioned
3824038241C92.00C92.01C92.02C92.40C92.41C92.42C92.50C92.51C92.52C92.60C92.61C92.62C92.A0C92.A1C92.A2
Original notice
Hematopoietic Cell Transplantation for Acute Myeloid Leukemia
bcbsms.com · Always check the source before changing claims.
Related changes
See all Blue Cross & Blue Shield of Mississippi changes →Genetic Testing for FLT3, NPM1, CEBPA, IDH1, and IDH2 Variants in Cytogenetically Normal Acute Myeloid LeukemiaMediumNo effective date · Medical PolicyHematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia/Small Lymphocytic LymphomaMediumNo effective date · Medical PolicyHematopoietic Cell Transplantation for Plasma Cell Dyscrasias, Including Multiple Myeloma and POEMS SyndromeMediumNo effective date · Medical PolicyHematopoietic Cell Transplantation for Non-Hodgkin LymphomasMediumNo effective date · Medical PolicyBrowse every Blue Cross & Blue Shield of Mississippi change in the policy list