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Excellus BlueCross BlueShieldCommercial · Coverage · Bone & Joints (Orthopedic) · Orthopedics, Pain Management, Neurosurgery +1 moreHigh impact

Epidural Steroid Injections 7.01.115

Act
by Oct 15, 2025
Effective date
Oct 15, 2025
Identified
Jun 20, 2026

Summary

Excellus BlueCross BlueShield updated their epidural steroid injection policy effective October 15, 2025, establishing specific medical necessity criteria for diagnostic nerve blocks and therapeutic epidural injections. The policy requires comprehensive pain management programs, specific imaging timeframes, and limits injection frequency to prevent denials.

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What to do

by Oct 15, 2025 · 3 steps
01Billing team must update prior authorization processes to verify patients meet all criteria including 4+ weeks conservative treatment, comprehensive pain management program participation (physical therapy, patient education, psychosocial support, oral medications), and advanced imaging within 24 months for cervical/thoracic injections.
02Providers must document 50%+ pain relief for repeat injections and ensure 14+ day intervals between sessions.
03Update encounter forms to capture required documentation elements to prevent claim denials.

Original notice

Epidural Steroid Injections 7.01.115
excellusbcbs.com · Always check the source before changing claims.
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Related changes

See all Excellus BlueCross BlueShield changes →
Epidural Steroid Injections 7.01.115MediumNo effective date · Bone & Joints (Orthopedic)Browse every Excellus BlueCross BlueShield change in the policy list

Related policy hubs

Excellus BlueCross BlueShield policiesOrthopedicsPain ManagementNeurosurgeryPM&R (Physical Medicine & Rehab)

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