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Blue Cross NCCommercial · Billing Codes · Medical Policy · NC · Pulmonology, Oncology, Plastic Surgery +2 moreMedium impact

Medical Policy Update for March 31, 2022

Act
by Mar 31, 2022
Effective date
Mar 31, 2022
Identified
Jun 16, 2026

Summary

Blue Cross Blue Shield of North Carolina updated multiple medical policies effective March 31, 2022, with significant changes to Endobronchial Valves coverage criteria, General Genetic Testing requirements, and new billing codes for Skin and Soft Tissue Substitutes and Sleep Apnea devices.

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What to do

by Mar 31, 2022 · 3 steps
01Billing team must update system with new codes A2011, A2012, A2013, A4100, Q4224, Q4225, Q4256, Q4257, Q4258 for skin/tissue substitutes effective 4/1/2022, and codes K1028, K1029 for sleep apnea management.
02Remove code 81301 and replace with 0268U for genetic testing.
03Update prior authorization requirements for Endobronchial Valves to require provider attestation of pulmonary rehabilitation enrollment instead of completion, and new collateral ventilation assessment criteria.

Codes mentioned

81301A2011A2012A2013A4100Q4224Q4225Q4256Q4257Q4258K1028K1029

Original notice

Medical Policy Update for March 31, 2022
bluecrossnc.com · Always check the source before changing claims.
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Related changes

See all Blue Cross NC changes →
Medical Policy Update for December 29, 2023HighEffective Jan 1, 2024 · Medical PolicyMedical Policy Update for May 16, 2023HighEffective May 16, 2023 · Medical PolicyMedical Policy Update for May 15, 2024HighEffective May 15, 2024 · Medical PolicyMedical Policy Update for May 17, 2022HighEffective May 17, 2022 · Medical PolicyBrowse every Blue Cross NC change in the policy list

Related policy hubs

Blue Cross NC policiesNC policy changesPulmonologyOncologyPlastic SurgerySleep MedicineWound CareCode 81301Code A2011Code A2012Code A2013Code A4100Code Q4224Code Q4225Code Q4256Code Q4257Code Q4258Code K1028Code K1029

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Medical Policy Mar 31, 2022 - Commercial | Blue Cross NC