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Blue Cross & Blue Shield of MississippiAll Plans · Coverage · Medical Policy · Hematology, OncologyMedium impact

Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

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

Summary

Allogeneic hematopoietic cell transplantation may be considered medically necessary to treat chronic lymphocytic leukemia or small lymphocytic lymphoma in individuals with markers of poor-risk disease. Autologous hematopoietic cell transplantation is considered investigational to treat chronic lymphocytic leukemia or small lymphocytic lymphoma, and allogeneic transplantation is considered investigational for these conditions except as noted above. No benefits will be provided for a covered transplant procedure or a transplant evaluation unless the member receives prior authorization through Case Management from Blue Cross & Blue Shield of Mississippi.

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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 before a covered transplant procedure or transplant evaluation, because no benefits will be provided without it.
02Document that allogeneic transplant (CPT 38240) for CLL or SLL is for individuals with markers of poor-risk disease, which the policy guidelines list as mutated TP53, IGHV mutation of 2% or less, del17p, del11q, or complex karyotype.
03Autologous transplant (CPT 38241) for CLL or SLL is investigational under this policy, so it should not be billed as medically necessary.
04For State and School Employee subscribers, all bone marrow and 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.
05For Federal Employee Program subscribers, the Service Benefit Plan includes specific conditions in which autologous or allogeneic transplants would be considered eligible for coverage.

Codes mentioned

382043820538206382403824138242S2140S2142S2150

Original notice

Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
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 PolicyNonmyeloablative Allogeneic Transplants of Hematopoietic Stem-Cells for Treatment of MalignancyMediumNo effective date · Medical PolicyHematopoietic Cell Transplantation for Plasma Cell Dyscrasias, Including Multiple Myeloma and POEMS SyndromeMediumNo 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 policiesHematologyOncologyCode 38204Code 38205Code 38206Code 38240Code 38241Code 38242Code S2140Code S2142Code S2150

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