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Medical Policy Update for October 1, 2024

Blue Cross NC·NC · Orthopedics, Pulmonology, Oncology +6 more·Medical Policy
Effective date
Oct 1, 2024
We identified it
Jun 16, 2026
Days to comply

Summary

Blue Cross Blue Shield of North Carolina updated multiple medical policies for October 1, 2024, primarily adding new PLA, CPT, and HCPCS codes across various testing and device categories. Key changes include increased allergen testing limits (20 to 40 per year), new coverage for certain medical devices, and numerous new billing codes for molecular testing and diagnostic procedures.

Action Required

Action needed
By October 1, 2024: Billing team must update billing system to include all new PLA codes (0502U, 0505U, 0506U, 0495U, 0514U, 0515U, and others listed) for molecular testing, pathogen panels, and genetic profiling. Update HCPCS codes for medical devices including orthotics (L1653, L1821) and stimulation devices (A4543, E0721, A4544, E0737). Remove discontinued compression device codes (E0650-E0673) and replace with E0683. Update allergen testing authorization limits from 20 to 40 tests per year effective October 15, 2024. Failure to use correct codes will result in claim denials.

Affected Billing Codes

A4543
E0721
L1653
L1821
A7021
E0469
E0650
E0651
E0652
E0655
E0656
E0657
E0660
E0665
E0666
E0667
E0668
E0669
E0670
E0671
E0672
E0673
E0683
E2513
A4544
E0737
C2596