CommercialAdministrativeMedium impact
Medical Policy Update for February 6, 2024
Blue Cross NC·NC · Oncology, Hematology·Medical Policy
Effective date
Feb 6, 2024
We identified it
Jun 16, 2026
Summary
Blue Cross NC consolidated two existing genetic testing policies (BCR-ABL1 Testing M2027 and Genetic Testing for Acute Myeloid Leukemia M2062) into a new comprehensive policy M2182 for Genomic Testing for Hematopoietic Neoplasms. The policy also updated the definition of Medical Necessity to align with North Carolina law and archived the Progesterone Therapy policy.
Action Required
By February 6, 2024: Billing teams must update prior authorization and coverage verification systems to reference new policy AHS-M2182 for all genomic testing related to blood cancers (hematopoietic neoplasms) instead of the archived policies M2027 and M2062. Update internal documentation and staff training materials to reflect the consolidated policy criteria and new Medical Necessity definition requirements for North Carolina.