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Blue Cross & Blue Shield of MississippiCommercial · Billing Codes · Medical Policy · MS · Hematology, Oncology, Transplant SurgeryMedium impact

Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia

Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

Allogeneic hematopoietic cell transplantation using a myeloablative conditioning regimen may be considered medically necessary as a treatment of chronic myeloid leukemia. Allogeneic hematopoietic cell transplantation using a reduced-intensity conditioning regimen may be considered medically necessary for individuals who meet clinical criteria for an allogeneic HCT but are not considered candidates for a myeloablative conditioning allogeneic HCT, and autologous HCT is investigational for chronic myeloid leukemia. The policy was reviewed 07/27/2026 with policy statements unchanged, and ICD-9 procedure and diagnosis codes were removed from the code reference.

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What to do

Action · 5 steps
01Obtain prior authorization through Case Management from Blue Cross & Blue Shield of Mississippi before a covered transplant procedure, because no benefits will be provided for a covered transplant procedure unless the member receives prior authorization.
02For State and School Employee subscribers, all bone marrow or stem cell transplants must be certified as medically necessary by the Plan's Utilization Review Vendor, and no benefits will be provided for any transplant procedure unless prior approval for the transplant is obtained.
03For reduced-intensity allogeneic HCT, document that the individual meets clinical criteria for an allogeneic HCT and is not a candidate for a myeloablative conditioning regimen, such as an individual whose age (typically older than 60 years) or comorbidities (for example liver or kidney dysfunction, generalized debilitation, prior intensive chemotherapy, or low Karnofsky Performance Status score) preclude a standard myeloablative regimen.
04Do not bill autologous HCT for chronic myeloid leukemia as medically necessary, because the policy classifies it as investigational.
05Services not documented to be medically necessary will not be paid.

Codes mentioned

3820538206382403824138242S2150C92.10C92.11C92.12

Original notice

Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia
bcbsms.com · Always check the source before changing claims.
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Related changes

See all Blue Cross & Blue Shield of Mississippi changes →
Hematopoietic 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 PolicyHematopoietic Cell Transplantation for Miscellaneous Solid Tumors in AdultsMediumNo effective date · Medical PolicyBrowse every Blue Cross & Blue Shield of Mississippi change in the policy list

Related policy hubs

Blue Cross & Blue Shield of Mississippi policiesMS policy changesHematologyOncologyTransplant SurgeryCode 38205Code 38206Code 38240Code 38241Code 38242Code S2150Code C92.10Code C92.11Code C92.12

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