CommercialBilling CodesMedium impact
Medical Policy Update for May 1, 2024
Blue Cross NC·NC · General Surgery, Gastroenterology, Pain Management +6 more·Medical Policy
Effective date
May 1, 2024
We identified it
Jun 16, 2026
Summary
Blue Cross Blue Shield of North Carolina updated multiple medical policies effective May 1, 2024, with changes to billing codes, coverage criteria, and policy guidelines across numerous specialties. Key changes include new CPT codes for neurostimulation and vascular procedures, updated coverage criteria for pneumatic compression pumps, and clarified guidelines for pain management procedures.
Action Required
By May 1, 2024: Billing teams must update billing systems to include new codes C1789 for breast surgeries, 91111 for wireless capsule endoscopy, 64555 for peripheral nerve stimulation, and codes 37243, 37244, 75894 for ovarian and internal iliac vein procedures. Update encounter forms and verify coverage criteria for pneumatic compression pumps now require documented failure of 4-week conservative therapy trial.