CommercialCoverageMedium impact
Medical Policy Update for June 12, 2024
Blue Cross NC·NC · Plastic Surgery, Oncology, Radiation Oncology +2 more·Medical Policy
Effective date
Jun 12, 2024
We identified it
Jun 16, 2026
Summary
Blue Cross NC updated multiple medical policies on June 12, 2024, with significant changes to Gender Affirmation Surgery coverage (reduced hormone therapy requirement from 12 to 6 months, added coverage for detransition procedures), IMRT radiation therapy criteria simplification, and updated CPT codes for neurophysiologic monitoring.
Action Required
Immediately: Update billing system to reflect CPT code changes - remove terminated codes 92585, 95974, 95975 and add new codes 92652, 92653 for neurophysiologic monitoring. Update prior authorization requirements for Gender Affirmation Surgery to reflect reduced 6-month hormone therapy requirement instead of 12 months. Add CPT 15830 as covered procedure and remove from non-covered list. Review IMRT radiation therapy claims as coverage criteria have been simplified.