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Blue Cross NCCommercial · Billing Codes · Medical Policy · NC · Pain Management, Anesthesiology, Orthopedics +2 moreMedium impact

Medical Policy Update for May 2, 2023

Act
immediately
Effective date
May 2, 2023
Identified
Jun 16, 2026

Summary

Blue Cross NC updated multiple medical policies on May 2, 2023, including significant changes to facet joint denervation coverage criteria and addition of CPT code J3490 for ketamine billing in chronic pain treatment. Most updates involved policy guidelines, references, and coverage criteria refinements across various specialties.

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What to do

immediately · 3 steps
01Update billing system to use CPT code J3490 for ketamine administration in chronic pain and psychiatric disorder treatments.
02Review facet joint denervation criteria - repeat procedures now allowed after 6 months with 50% documented pain relief, without requiring repeat blocks.
03Update encounter forms and provider documentation requirements for these procedures.

Codes mentioned

J3490

Original notice

Medical Policy Update for May 2, 2023
bluecrossnc.com · Always check the source before changing claims.
View original ↗

Related changes

See all Blue Cross NC changes →
Medical Criteria Update for April 6, 2022MediumEffective Apr 6, 2022 · Medical PolicyMedical Policy Update for December 29, 2023HighEffective Jan 1, 2024 · Medical PolicyMedical Policy Update for April 1, 2024MediumEffective Apr 1, 2024 · Medical PolicyBrowse every Blue Cross NC change in the policy list

Related policy hubs

Blue Cross NC policiesNC policy changesPain ManagementAnesthesiologyOrthopedicsNeurologyPsychiatryCode J3490

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