CommercialBilling CodesMedium impact
Medical Policy Update for May 2, 2023
Blue Cross NC·NC · Pain Management, Anesthesiology, Orthopedics +2 more·Medical Policy
Effective date
May 2, 2023
We identified it
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.
Action Required
Immediately: Update billing system to use CPT code J3490 for ketamine administration in chronic pain and psychiatric disorder treatments. Review facet joint denervation criteria - repeat procedures now allowed after 6 months with 50% documented pain relief, without requiring repeat blocks. Update encounter forms and provider documentation requirements for these procedures.