High impact
2025 August Medical Policy Updates
BlueCross BlueShield of South Carolina·Effective Aug 28, 2025
BlueCross BlueShield of South Carolina and BlueChoice HealthPlan released 44 updated medical policies effective August 28, 2025. Most are routine annual reviews with no coverage intent changes but updated evidence and references. However, several policies contain actionable billing code changes and expanded coverage criteria: CAM 127 (Hepatitis Testing) adds HCPCS G0567 and expands coverage for immunosuppressant therapy patients; CAM 277 (Serum Tumor Markers) removes CPT 83615; multiple genetic testing policies add or remove CPT codes; and CAM 320 (Familial Hypercholesterolemia) was completely rewritten with new coverage criteria. Billing teams must immediately update systems for code additions/removals and expanded testing criteria.