CommercialCoverageMedium impact
Medical Policy Update for July 16, 2025
Blue Cross NC·NC · Endocrinology, Cardiology, Orthopedics +4 more·Medical Policy
Effective date
Jul 16, 2025
We identified it
Jun 16, 2026
Summary
Blue Cross Blue Shield of North Carolina updated 32 medical policies effective July 16, 2025, including significant changes to continuous glucose monitoring (removed requirement for multiple daily insulin doses), new investigational determinations for remote electrical neuromodulation for migraines and renal denervation procedures, and updates to artificial pancreas device systems coverage guidelines.
Action Required
By July 16, 2025: Billing team must review and update prior authorization requirements and coverage determination workflows for continuous glucose monitoring (no longer requires multiple daily insulin doses), artificial pancreas device systems, cardiac transplantation, implantable cardioverter defibrillators, and percutaneous left atrial appendage closure devices. Mark remote electrical neuromodulation for migraines and renal denervation procedures as investigational/non-covered. Update encounter forms and billing system rules to reflect policy guideline changes for orthopedic procedures including autografts/allografts for cartilage lesions and autologous chondrocyte implantation.