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Blue Cross & Blue Shield of MississippiAll Plans · Coverage · Medical Policy · Hematology, Oncology, Transplant SurgeryMedium impact

Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms

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

Summary

8.01.21 on allogeneic hematopoietic cell transplantation for myelodysplastic syndromes and myeloproliferative neoplasms. Myeloablative allogeneic transplant may be considered medically necessary as a treatment for these disorders, and reduced-intensity conditioning allogeneic transplant may be considered medically necessary as a risk-adapted treatment for individuals at high risk of intolerance of a myeloablative regimen. Myeloablative or reduced-intensity allogeneic transplant for cases that do not meet the policy guidelines criteria is investigational. A 07/23/2026 policy review updated the description with minor changes, left the policy statements unchanged and removed ICD-9 procedure and diagnosis codes from the code reference.

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What to do

Action · 5 steps
01Billing team: Get prior authorization through Case Management from Blue Cross & Blue Shield of Mississippi for a covered transplant procedure or a transplant evaluation, because no benefits will be provided without it.
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 is obtained.
03For Federal Employee Program subscribers, check the specific conditions in the Service Benefit Plan under which transplants are eligible for coverage.
04Bill the codes in the code reference only when the procedure is performed according to the policy section, because those codes are only medically necessary under that condition.
05Treat myeloablative or reduced-intensity allogeneic transplant that does not meet the policy guidelines criteria as investigational and not medically necessary under this policy.

Codes mentioned

3820438205382073820838209382103821138212382133821438215382203822138222382303824038242868128681386816868178682186825868269640196402964059640696409964119641396415964169641796420964229642396425964409644696450965219652296523Q0083Q0084Q0085S2150D47.3D47.1D47.4D47.Z2C88.8C94.6D47.9D47.Z9D75.81

Original notice

Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms
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 Miscellaneous Solid Tumors in AdultsMediumNo effective date · Medical PolicyHematopoietic Cell Transplantation in the Treatment of Germ Cell TumorsMediumNo effective date · Medical PolicyHematopoietic Cell Transplantation for Solid Tumors of ChildhoodMediumNo effective date · Medical PolicyHematopoietic Cell Transplantation for Primary Amyloidosis or Waldenstrom's MacroglobulinemiaMediumNo 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 policiesHematologyOncologyTransplant SurgeryCode 38204Code 38205Code 38207Code 38208Code 38209Code 38210Code 38211Code 38212Code 38213Code 38214Code 38215Code 38220Code 38221Code 38222Code 38230Code 38240Code 38242Code 86812Code 86813Code 86816Code 86817Code 86821Code 86825Code 86826Code 96401Code 96402Code 96405Code 96406Code 96409Code 96411Code 96413Code 96415Code 96416Code 96417Code 96420Code 96422Code 96423Code 96425Code 96440Code 96446Code 96450Code 96521Code 96522Code 96523Code Q0083Code Q0084Code Q0085Code S2150Code D47.3Code D47.1Code D47.4Code D47.Z2Code C88.8Code C94.6Code D47.9Code D47.Z9Code D75.81

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