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Medical Policy Update for May 16, 2023

Blue Cross NC·NC · Gastroenterology, Endocrinology, Oncology +4 more·Medical Policy
Effective date
May 16, 2023
We identified it
Jun 16, 2026
Days to comply

Summary

Blue Cross Blue Shield of North Carolina updated 25+ medical policies effective May 16, 2023, including expanded coverage for diabetes testing, esophageal pathology testing, hepatitis testing, and liquid biopsy. Multiple billing codes were added or removed across various specialties, and fibromyalgia testing is now considered investigational and non-covered.

Action Required

Action needed
Immediately: Billing team must update billing software to include new CPT codes 82951, 82952 for diabetes testing; codes 86704-87517, G0499 for hepatitis testing; and codes 81194-0368U for liquid biopsy. Remove deleted codes 0324U, 0325U, 81301, 81404, 0239U, 0242U, 0346U, 81449, 81451, 81456 from billing system. Stop billing for fibromyalgia testing as it is now investigational and non-covered. Update encounter forms and notify providers of expanded coverage criteria for diabetes, hepatitis, and esophageal testing.

Affected Billing Codes

82951
82952
81479
86704
86705
86706
87340
87341
87517
G0499
81194
81210
81275
81276
81405
81406
81301
81404
81449
81451
81456