CommercialBilling CodesMedium impact
Medical Policy Update for April 1, 2025
Blue Cross NC·NC · ENT (Ear, Nose & Throat), Endocrinology, Cardiology·Medical Policy
Effective date
Apr 1, 2025
We identified it
Jun 16, 2026
Summary
Blue Cross NC updated multiple genetic testing and specialty procedure policies effective April 1, 2025, adding new CPT codes for genetic testing, removing others, and revising coverage criteria for balloon sinuplasty and continuous glucose monitoring. The changes primarily affect genetic testing billing codes and documentation requirements.
Action Required
By April 1, 2025: Billing team must update billing software to add new genetic testing codes (0547U, 0548U, 0551U, 0541U, 81437, 81438, 81449, 81456, 81403, 81404, 81405, 81479, 88230, 88248, 88249, 88291) and remove discontinued codes (G0564, G0565, 96040, S0265). Update encounter forms and notify providers of revised coverage criteria for genetic testing and balloon sinuplasty procedures.