CommercialCoverageMedium impact
Medical Policy Update for April 18, 2023
Blue Cross NC·NC · Urology, OB-GYN, Oncology +2 more·Medical Policy
Effective date
Apr 18, 2023
We identified it
Jun 16, 2026
Summary
Blue Cross NC updated three policies effective April 18, 2023: 1) Modified coverage for vaginitis PCR testing - now covers single-target bacterial vaginosis tests but excludes multi-target panels, 2) Added new coverage for Remote Therapeutic and Physiologic Monitoring when medically necessary, 3) Added three new urinary tumor marker codes for bladder cancer testing.
Action Required
Immediately: Update billing system to include new codes 0365U, 0366U, and 0367U for urinary tumor markers in bladder cancer cases. For practices performing vaginitis testing, update prior authorization rules to allow single-target bacterial vaginosis PCR tests but deny multi-target panels (BD MAX Vaginal Panel, NuSwab VG, Xpert Xpress MVP). For practices offering remote monitoring, verify medical necessity documentation requirements are in place before billing.