Organ transplants that do not require prior approval are:
- bone marrow
- peripheral hematopoietic stem cells (autologous, syngeneic or allogeneic)
For organs that need prior approval, providers must submit clinical documentation to the Division of Medicaid’s Utilization Management/Quality Improvement Organization (UM/QIO) for medical necessity.
Detailed information regarding organ transplant can be found in the Mississippi Administrative Code Title 23, Part 202, Chapter 4, Rule 4.7.