CommercialBilling CodesMedium impact
Medical Policy Update for September 4, 2024
Blue Cross NC·NC · Oncology, Neurology, Cardiology +5 more·Medical Policy
Effective date
Sep 4, 2024
We identified it
Jun 16, 2026
Summary
Blue Cross NC updated multiple genetic testing policies with new coverage criteria, billing code changes, and documentation requirements. Key changes include new covered conditions, removed obsolete codes, and updated references to genetic panel testing guidelines across 20+ genetic testing policies.
Action Required
Immediately: Update billing systems to remove obsolete codes 0354U, 96040, S0265, and 90640 from genetic testing claims. Add new PLA codes 0113U, 0403U, 0444U, and CPT 81404 for covered genetic testing services. Review genetic counseling documentation requirements and ensure all genetic panel testing references policy AHS-R2162. Claims using removed codes will be denied.