What insurance policy changes affect HCPCS K0378?

There are 3 tracked policy changes affecting HCPCS K0378, including updates from Premera Blue Cross. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS K0378?

Payers that have issued tracked updates for HCPCS K0378 include: Premera Blue Cross.

How do I get notified when HCPCS K0378 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS K0378. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for HCPCS K0378?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

PAYER POLICY CHANGES

K0378 Insurance Policy Changes

HCPCS K0378 is referenced in 3 tracked payer policy changes from Premera Blue Cross. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS K0378 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Premera Blue Cross · Identified Jun 16, 2026High impact
Medical Policy and Coding Updates - November 2024
Premera's November 2024 medical policy and coding update changes medical necessity criteria for several drugs and services, including Dupixent, Xolair, trastuzumab and rituximab products, and GnRH analogs. It also adds coding updates that require review for medical necessity and prior authorization, including knee arthroplasty codes 27440, 27442, 27443 and 27445, amyloid antibody code J0175, and codes for biofeedback, endometrial ablation, home apnea monitoring and posterior tibial nerve stimulators.
Premera Blue Cross · Identified Jun 16, 2026High impact
Medical Policy and Coding Updates - December 2024
Premera's December 2024 medical policy and coding update adds medical necessity criteria for lymphedema and lipedema surgery, a new shoulder arthroplasty policy, and new or revised criteria for drugs including Ocrevus Zunovo, Dupixent, Ebglyss, Leqselvi and Wegovy. It also lists coding updates that require review for medical necessity and prior authorization, including cervical spine surgery codes 63001, 63015, 63040, 63050, 63051, 63075, 63081 and 63265, and it places infusion drugs such as Tyruko and Alyglo under site-of-service review.
Premera Blue Cross · Identified Jun 16, 2026Medium impact
Medical Policy and Coding Updates - October 2024
Effective January 3, 2025, Premera HMO medical necessity criteria for Dupixent (dupilumab) in moderate to severe asthma were updated, requiring two or more asthma exacerbations in the previous 12 months requiring oral corticosteroids, or one or more exacerbations requiring hospitalization, an emergency department visit, or an urgent care visit, or forced expiratory volume in 1 second of less than 80% predicted, with a blood eosinophil count greater than 300 cells/mcL. The same effective date added Humira (adalimumab) criteria for psoriatic arthritis, Crohn's disease, ulcerative colitis, uveitis, sarcoidosis and pyoderma gangrenosum, moved Inflectra (infliximab-dyyb) to a first-line TNF-alpha antagonist option for several indications, and removed Hyrimoz (adalimumab-adaz) from first-line options. A new Shoulder Arthroplasty policy (7.01.590) with medical necessity criteria for total, reverse, hemi, and revision shoulder arthroplasty is also listed under the January 3, 2025 effective date, and Restasis (cyclosporine ophthalmic emulsion) was added for dry eye disease in individuals aged 18 years and older effective October 1, 2024.

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Medical Policy and Coding Updates - November 2024

Medical Policy and Coding Updates - December 2024

Medical Policy and Coding Updates - October 2024

What insurance policy changes affect HCPCS K0378?

Which payers have updated policy for HCPCS K0378?

How do I get notified when HCPCS K0378 policy changes?

Why do payers change policies for HCPCS K0378?