High impact
Hysterectomy
Regence BlueShield·Effective Jul 1, 2026
This new hysterectomy prior authorization policy (effective July 1, 2026) establishes specific medical necessity criteria for hysterectomy procedures across nine clinical indications. Billing teams must now obtain prior authorization and ensure clinical documentation supports one of nine approved conditions before submitting claims. Claims submitted without meeting these criteria or proper documentation will be denied.