All PlansCoverageMedium impact
Endometrial Ablation
Blue Cross & Blue Shield of Mississippi·MS · OB-GYN·Medical Policy
We identified it
Jun 20, 2026
Summary
This is a new comprehensive policy establishing coverage criteria for endometrial ablation procedures using FDA-approved devices. The policy defines medical necessity requirements for women with abnormal uterine bleeding who have failed hormone therapy and lists specific contraindications that would make the procedure investigational.
Action Required
Immediately: Review all pending and future endometrial ablation claims to ensure patients meet medical necessity criteria (abnormal uterine bleeding, failed hormone therapy, candidates for hysterectomy). Verify absence of contraindications including pregnancy, endometrial cancer history, active infections, IUD placement, or anatomic conditions. Update prior authorization processes to check these specific requirements. Claims not meeting criteria will be considered investigational and denied.