CommercialCoverageHigh impact
Medical Policy Update for July 1, 2024
Blue Cross NC·NC · Cardiology, Psychiatry, Orthopedics +4 more·Medical Policy
Effective date
Jul 1, 2024
We identified it
Jun 16, 2026
Summary
Blue Cross Blue Shield of North Carolina updated multiple medical policies effective July 1, 2024, including new coverage for psychiatric and substance abuse programs, expanded cardiac monitoring coverage, new billing codes for skin substitutes and neurostimulation, and coverage criteria updates for orthotics including custom knee braces.
Action Required
Immediately (policy already effective): Update billing systems to include new HCPCS codes Q4311-Q4333 for skin substitutes, CPT codes 0882T and 0883T for neurostimulation, and code C1605 for leadless cardiac pacemakers. Remove deleted CPT code 0204U from thyroid molecular marker billing. Update prior authorization workflows for new psychiatric IOP/PHP and substance use disorder programs. Verify custom knee brace coverage criteria documentation requirements. Train billing staff on expanded ambulatory cardiac monitoring and outpatient cardiac telemetry coverage criteria.