CommercialCoverageHigh impact
Medical Policy Update for May 31, 2022
Blue Cross NC·NC · ENT (Ear, Nose & Throat), Oncology, Radiology +1 more·Medical Policy
Effective date
May 31, 2022
We identified it
Jun 16, 2026
Summary
Blue Cross NC updated numerous medical policies effective May 31, 2022, including coverage changes for balloon sinuplasty requiring air fluid levels or opacification, new investigational status for radiofrequency and laser ablation for chronic rhinitis, updated coverage criteria for prostate cancer gene expression profiling, and removal of terminated CPT codes 77785-77787 for brain cancer brachytherapy.
Action Required
By May 31, 2022: Billing team must stop using terminated CPT codes 77785-77787 for brain cancer brachytherapy. Update billing system to add new CPT codes 77431 and 77470 for radiosurgery services. Add PLA codes 0137U, 0067U, and 0295U for liquid biopsy and breast cancer molecular testing. Update prior authorization requirements for balloon sinuplasty to require documentation of air fluid levels or opacification. Mark radiofrequency and laser ablation for chronic rhinitis as investigational (non-covered).