CommercialCoverageHigh impact
Upcoming Policies effective October 6, 2025
Blue Cross and Blue Shield of Minnesota·Oncology, Hematology, Orthopedics +2 more·Medical Policy
Effective date
Oct 6, 2025
We identified it
Jun 20, 2026
Summary
Major updates to hematopoietic stem cell transplant coverage criteria for Non-Hodgkin lymphoma and new comprehensive medical necessity requirements for sacroiliac joint fusion procedures, including specific documentation and prior authorization requirements.
Action Required
By October 6, 2025: Billing team must update prior authorization workflows for hematopoietic stem cell transplants and sacroiliac joint fusion procedures. Update system to require comprehensive documentation including imaging reports, injection trials, and 6-month conservative treatment documentation for SI joint fusions. Train staff on new medical necessity criteria for NHL transplant coverage categories. Claims without proper documentation will be denied.