CommercialCoverageMedium impact
Whole Gland Cryoablation of Prostate Cancer
Blue Cross & Blue Shield of Mississippi·MS · Urology, Oncology·Medical Policy
We identified it
Jun 20, 2026
Summary
This is a current medical policy update for whole gland cryoablation of prostate cancer, confirming it remains medically necessary for initial treatment of organ-confined prostate cancer and as salvage therapy after failed radiotherapy. The policy clarifies coverage criteria and billing codes for this procedure.
Action Required
Immediately: Verify billing system has CPT 55873 configured as covered for whole gland cryoablation when performed for organ-confined prostate cancer (initial treatment) or salvage therapy after radiotherapy failure. Ensure claims include appropriate diagnosis codes C61 or 198.82. Update encounter forms to reflect medical necessity criteria requiring documentation of organ-confined disease or prior radiotherapy failure.