CommercialCoverageMedium impact
Medical Policy Update for January 15, 2025
Blue Cross NC·NC · Plastic Surgery, General Surgery, Dermatology·Medical Policy
Effective date
Jan 15, 2025
We identified it
Jun 16, 2026
Summary
Blue Cross and Blue Shield of North Carolina updated their medical policy to clarify that liposuction, excision, and debulking procedures are not covered when used for surgical treatment of lipedema. This clarification was added to the 'When Not Covered' section for consistency.
Action Required
Immediately: Billing team must verify that all lipedema treatment claims using liposuction, excision, or debulking procedures are flagged as non-covered for Blue Cross NC members. Update billing system notes to reflect this exclusion and inform providers that these procedures will be denied for lipedema diagnosis codes.