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CommercialBilling CodesMedium impact

Medical Policy Update for April 17, 2024

Blue Cross NC·NC · Neurology, Rheumatology, Cardiology +3 more·Medical Policy
Effective date
Apr 17, 2024
We identified it
Jun 16, 2026
Days to comply

Summary

Blue Cross NC added multiple new CPT codes to various medical policies and updated coverage criteria for perirectal spacers during prostate cancer treatment. The billing code additions were effective 4/1/24, while the perirectal spacer policy change is effective 4/17/24.

Action Required

Action needed
Immediately: Billing team must update system to include new CPT codes 0443U, 0445U, 0446U, 0447U, 0439U, 0440U, 0449U, 0441U, and 0442U for respective diagnostic categories. Update encounter forms and billing software. For urology practices: Stop billing perirectal spacer placement (SpaceOAR) with proton beam therapy as it is now considered not medically necessary and claims will be denied.