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Upcoming Policies effective July 7, 2025
Blue Cross and Blue Shield of Minnesota·MN · Orthopedics, Neurosurgery, Oncology +1 more·Medical Policy
Effective date
Jul 7, 2025
We identified it
Jun 20, 2026
Summary
Blue Cross Minnesota revised their cervical spinal fusion policy (IV-181) with stricter medical necessity criteria including mandatory 6-week smoking cessation requirements and specific conservative treatment protocols. They also added coverage for absorbable perirectal spacers during prostate cancer radiotherapy and inactivated the hippotherapy policy.
Action Required
By July 7, 2025: Update prior authorization processes for cervical spinal fusion procedures to include new documentation requirements: 6-week smoking cessation verification, specific pain scale scores (VAS/NRS ≥7 or ODI ≥25), mandatory conservative treatment documentation (6 weeks activity modification, prescription medications, epidural injections), and recent imaging within 6 months. Add perirectal spacer coverage for prostate radiotherapy to approved procedures list. Remove hippotherapy from covered services.