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Blue Cross NCCommercial · Coverage · Medical Policy · NC · Gastroenterology, Infectious Disease, Internal Medicine +1 moreHigh impact

Medical Policy Update December 10, 2025

Act
immediately
Effective date
Dec 10, 2025
Identified
Jun 16, 2026

Summary

Blue Cross Blue Shield of North Carolina updated multiple medical policies effective December 10, 2025, with significant changes to hepatitis testing coverage (adding HCPCS G0567 and expanding immunocompromised patient criteria), nucleic acid probe testing (removing several direct probe tests from coverage), and pancreatic enzyme testing (removing amylase coverage for most indications).

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What to do

immediately · 4 steps
01Update billing system to include new HCPCS code G0567 for hepatitis testing in immunocompromised patients.
02Stop billing codes 87480, 87481, and 87482 for direct probe nucleic acid testing - these are now non-covered.
03Remove serum amylase testing from most pancreatic enzyme panels except for pancreatic cyst fluid analysis.
04Update encounter forms and provider documentation requirements for hepatitis testing frequency changes (HCV antibody testing now every 3 months for high-risk patients).
If missed: Failure to comply will result in claim denials.

Codes mentioned

G0567874808748187482

Original notice

Medical Policy Update December 10, 2025
bluecrossnc.com · Always check the source before changing claims.
View original ↗

Related policy hubs

Blue Cross NC policiesNC policy changesGastroenterologyInfectious DiseaseInternal MedicineFamily MedicineCode G0567Code 87480Code 87481Code 87482

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