CommercialAdministrativeMedium impact
Medical Policy Update for January 24, 2024
Blue Cross NC·NC · Orthopedics, PM&R (Physical Medicine & Rehab), General Practice +2 more·Medical Policy
Effective date
Jan 24, 2024
We identified it
Jun 16, 2026
Summary
Blue Cross Blue Shield of North Carolina added Modifier Guidelines to the Related Policies section for Durable Medical Equipment (DME) reimbursement. This update affects how DME claims should be processed and billed with appropriate modifiers.
Action Required
Immediately: Billing team must review the new Modifier Guidelines in the Related Policies section for DME claims. Update billing procedures to ensure correct modifier usage for all durable medical equipment claims per the new guidelines. Verify staff training on proper modifier application to prevent claim denials.