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CommercialCoverageMedium impact

B-Natriuretic Peptide

Blue Cross & Blue Shield of Mississippi·MS · Cardiology, Emergency Medicine, Internal Medicine +1 more·Medical Policy
Effective date
Nov 17, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

This is a BCBS Mississippi policy update on B-Natriuretic Peptide (BNP) and NT-proBNP testing. The policy confirms these tests are medically necessary for diagnosing congestive heart failure and risk stratification after acute coronary events, but considers them investigational for routine screening. Recent updates removed ICD-9 codes and deleted ICD-10 code I24.8.

Action Required

Action needed
By November 17, 2025: Billing team must update systems to remove deleted ICD-10 code I24.8 and ensure BNP/NT-proBNP tests are only billed with appropriate heart failure or acute coronary event diagnoses. Verify documentation supports medical necessity and avoid billing for routine screening purposes as these will be denied as investigational.

Affected Billing Codes

I16.0
I16.1
I16.9
J98.51
J98.59
I50.810
I50.811
I50.812
I50.813
I50.814
I50.82
I50.83
I50.84
I50.89
R06.03
I26.93
I26.94
N18.30
N18.31
N18.32
R05.1
R05.2
R05.3
R05.8
R05.9
I34.81
I34.89
I24.81
I24.89
I47.10
I47.11
I47.19