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Medical Policy Update for September 13, 2022

Blue Cross NC·NC · Oncology, Hematology, Gastroenterology +3 more·Medical Policy
Effective date
Sep 13, 2022
We identified it
Jun 16, 2026
Days to comply

Summary

Blue Cross NC updated 24 medical policies on September 13, 2022, with significant changes to genetic testing coverage criteria, billing code additions/removals, and new coverage for chromosomal microarray testing for CNS tumors. Key billing code changes include removal of CPT 81401, 81404, 81479, and 84540, plus addition of codes 82705 and S3708.

Action Required

Action needed
Immediately: Billing team must update system to remove CPT codes 81401, 81404, 81479, 84540, and 87623 from covered services. Add new codes 82705 and S3708 to billing system. Update flow cytometry billing rules for CPT 88187-88189 to limit to 2 specimens per date of service and one unit per specimen, with no combination billing allowed. Review genetic testing authorization requirements for updated coverage criteria, especially chromosomal microarray testing which now covers CNS tumors but excludes co-testing with low-pass WGS.

Affected Billing Codes

81401
81404
81479
84540
82705
S3708
87623
88187
88188
88189