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CommercialBilling CodesMedium impact

Medical Policy Update for February 7, 2023

Blue Cross NC·NC · Family Medicine, Internal Medicine, OB-GYN +5 more·Medical Policy
Effective date
Feb 7, 2023
We identified it
Jun 16, 2026
Days to comply

Summary

Blue Cross NC updated multiple medical policies effective February 7, 2023, with significant changes to genetic testing coverage criteria, new billing codes for general genetic testing, and updated guidelines for coronavirus testing, nasal procedures, and prenatal testing. Most changes involve clarified coverage criteria and updated billing/coding sections.

Action Required

Action needed
Immediately: Billing team must update billing software to include new CPT codes 81329, 81333, 81336, 81337, 81442, 81470, 81471 and PLA codes 0232U, 0230U, 0322U, 0334U, 0341U for genetic testing. Remove CPT codes 89290, 89291, and PLA code 0050U from system. Update prior authorization requirements for genetic testing per revised coverage criteria. Review coronavirus testing billing to ensure compliance with updated reimbursement restrictions for antibody serology testing.

Affected Billing Codes

81329
81333
81336
81337
81442
81470
81471
81244