Important Updates to Policies, Codes, Provider Handbook, and Preventive Guide
Blue Cross Vermont is implementing eight medical policy updates effective January 1, 2027, including clarifications on hospital bed coverage (HCPCS E0310), ketamine indications and severity thresholds, anesthesia documentation requirements, and coding changes for varicose vein treatment (removal of CPT 37243, addition of CPT 76942, reclassification of CPT 36468 to contract exclusion). A new policy establishes medical necessity for three nontraditional cardiovascular biomarkers (Apolipoprotein B, high-sensitivity C-reactive protein, Lipoprotein(a)), and genetic testing policy adds CPT 0449U requiring prior approval.