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Blue Cross NCCommercial · Billing Codes · Medical Policy · NC · Oncology, Neurology, Cardiology +5 moreMedium impact

Medical Policy Update for September 4, 2024

Act
immediately
Effective date
Sep 4, 2024
Identified
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.

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What to do

immediately · 4 steps
01Update billing systems to remove obsolete codes 0354U, 96040, S0265, and 90640 from genetic testing claims.
02Add new PLA codes 0113U, 0403U, 0444U, and CPT 81404 for covered genetic testing services.
03Review genetic counseling documentation requirements and ensure all genetic panel testing references policy AHS-R2162.
04Claims using removed codes will be denied.

Codes mentioned

96040S02659064081404

Original notice

Medical Policy Update for September 4, 2024
bluecrossnc.com · Always check the source before changing claims.
View original ↗

Related changes

See all Blue Cross NC changes →
Medical Policy Update for April 1, 2025MediumEffective Apr 1, 2025 · Medical PolicyMedical Policy Update for December 13, 2022HighEffective Dec 13, 2022 · Medical PolicyMedical Policy Update for February 21, 2024MediumEffective Feb 21, 2024 · Medical PolicyMedical Policy Update for May 15, 2024HighEffective May 15, 2024 · Medical PolicyBrowse every Blue Cross NC change in the policy list

Related policy hubs

Blue Cross NC policiesNC policy changesOncologyNeurologyCardiologyGastroenterologyOphthalmologyFamily MedicineInternal MedicinePediatricsCode 96040Code S0265Code 90640Code 81404

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Medical Policy Sep 4, 2024 - Commercial | Blue Cross NC