CommercialCoverageMedium impact
Medical Policy Update for February 21, 2024
Blue Cross NC·NC · Family Medicine, Internal Medicine, Endocrinology +3 more·Medical Policy
Effective date
Feb 21, 2024
We identified it
Jun 16, 2026
Summary
Blue Cross NC updated 24 medical policies effective February 21, 2024, including significant changes to diabetes screening (now covers fasting glucose every 3 years for ages 35+), vaginitis diagnosis testing panels, genetic testing criteria for multiple conditions, and cancer-related molecular testing coverage.
Action Required
By February 21, 2024: Billing team must update system rules for diabetes screening to allow fasting glucose tests every 3 years for asymptomatic patients 35+ with no risk factors. Remove billing codes 96040 and S0265 from genetic testing (Fanconi Anemia and Mitochondrial Disorders). Add new PLA codes 0329U and 0019U for proteogenomic cancer testing. Update prior authorization requirements for new vaginitis panel testing and genetic testing criteria per updated coverage guidelines.