CommercialCoverageMedium impact
Medical Policy Update October 29, 2025
Blue Cross NC·NC · Plastic Surgery, Urology, OB-GYN +7 more·Medical Policy
Effective date
Oct 29, 2025
We identified it
Jun 16, 2026
Summary
Blue Cross Blue Shield of North Carolina updated 25 medical policies with primarily administrative changes including updated references, policy guidelines, and descriptions. Key changes include removing specific CPT codes from gender-affirming care procedures and clarifying that baroreflex stimulation devices are investigational for all applications.
Action Required
Immediately: Review billing for gender-affirming care procedures - CPT codes 19340, 21499, 54406, 54408, 54415, 55175, and 55180 have been removed from covered services. Billing team must verify alternative coding options and update encounter forms. For baroreflex stimulation devices, note that all applications are now considered investigational and may not be covered.