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CommercialCoverageMedium impact

Medical Policy Update for March 7, 2023

Blue Cross NC·NC · ENT (Ear, Nose & Throat), PM&R (Physical Medicine & Rehab), Orthopedics·Medical Policy
Effective date
Mar 7, 2023
We identified it
Jun 16, 2026
Days to comply

Summary

Blue Cross Blue Shield of North Carolina updated multiple medical policies effective March 7, 2023, with key changes including removal of hearing aid coverage for members under 22, addition of new billing codes for observation services, development of a new inpatient interfacility transfer policy, and removal of medical director discussion requirement for private duty nursing requests.

Action Required

Action needed
By March 7, 2023: Billing team must update system to include new observation room billing codes 99221-99223, 99231-99233, and 99238-99239. Remove code E1399 from powered exoskeleton billing options. Update prior authorization workflows to remove automatic medical director consultation requirement for private duty nursing services. Review hearing aid benefit coverage limitations for members under age 22.

Affected Billing Codes

99221
99222
99223
99231
99232
99233
99238
99239
E1399