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Medical Policy Update for December 30, 2022

Blue Cross NC·NC · Cardiology, General Surgery, Gastroenterology +10 more·Medical Policy
Effective date
Jan 1, 2023
We identified it
Jun 16, 2026
Days to comply

Summary

Blue Cross Blue Shield of North Carolina updated multiple medical policies effective January 1, 2023, with significant billing code changes across various specialties. Key changes include deleted codes for ambulatory monitoring, new codes for bariatric surgery, bone density studies, and various diagnostic tests, plus updated coverage criteria for private duty nursing services.

Action Required

Action needed
By January 1, 2023: Billing team must immediately update billing system to remove deleted codes (0497T, 0498T, 0163T, 43659 for OAGB, 0312T-0317T, G0308, G0309, 99217-99220, 99224-99226, C1841, C1842, C1849, 33240 duplicate, 81403) and add new codes (22860, 43645, 43290, 43291, 0358U, 0743T, 0749T, 0750T, 0781T, 0782T, 0740T, 0741T, A4239, E2103, 0783T, C7509-C7511, 0777T, 0359U, 81441, 81449, 81451, 81456, 81479, 69728-69730, C7537-C7540, 0355U, 0357U, 0361U, 0356U, 81418, 0362U, 0775T, Q4236, Q4262-Q4264). Update encounter forms and notify providers of bariatric surgery code changes and new investigational procedures. Claims using deleted codes after January 1 will be denied.

Affected Billing Codes

22860
43659
43645
43999
43290
43291
A4239
E2103
G0308
G0309
C7509
C7510
C7511
81441
81449
81451
81456
81403
81479
69728
69729
69730
C7537
C7538
C7539
C7540
33240
99217
99218
99219
99220
99224
99225
99226
81418
C1841
C1842
Q4236
Q4262
Q4263
Q4264
C1849