CommercialCoverageMedium impact
Medical Policy Update for April 30, 2025
Blue Cross NC·NC · Family Medicine, Internal Medicine, Pediatrics +2 more·Medical Policy
Effective date
Apr 30, 2025
We identified it
Jun 16, 2026
Summary
Blue Cross NC updated multiple medical policies effective April 30, 2025, including changes to COVID-19 testing frequency (once every 48 hours), diabetes testing for pregnant patients (quarterly), developmental delay testing criteria, vitamin testing frequencies, and 3D printed orthopedic implant coverage requirements.
Action Required
By April 30, 2025: Billing team must stop using removed CPT codes 87631, 87632, 87633, 0115U, 0202U, 0223U, 0225U, and C9803 for COVID-19 testing. Update billing system to limit vitamin B12 testing frequency to once every three months. Update prior authorization requirements for 3D printed orthopedic implants to require FDA approval at central manufacturing facilities. Providers must document quarterly diabetes testing for pregnant patients and updated criteria for developmental delay testing.