CommercialBilling CodesHigh impact
Medical Policy Update for May 15, 2024
Blue Cross NC·NC · Rheumatology, Oncology, Hematology +7 more·Medical Policy
Effective date
May 15, 2024
We identified it
Jun 16, 2026
Summary
Blue Cross NC updated 24 medical policies effective May 15, 2024, with multiple changes to coverage criteria, billing codes, and documentation requirements across various specialties including rheumatology, oncology, genetic testing, and infectious disease testing.
Action Required
By May 15, 2024: Billing team must update billing software to reflect new CPT codes for biomarker testing (86200, 86430, 86431), liquid biopsy (0388U, 0395U), myeloproliferative neoplasm testing (multiple genetic codes), and pre-implantation genetic testing. Remove discontinued codes including 84999 and 81350. Update prior authorization requirements for rheumatoid factor and anti-CCP testing to once per lifetime unless significant symptom changes occur. Verify nucleic acid amplification testing coverage for failed onychomycosis treatments. Claims using old codes or not meeting new criteria will be denied.