CommercialPrior AuthHigh impact
MPC November 2025
Blue Cross Blue Shield of Nebraska·NE · Cardiology, Radiology, Endocrinology +5 more·Medical Policy
Effective date
Feb 15, 2026
We identified it
Jun 24, 2026
Summary
Blue Cross Blue Shield of Nebraska has updated multiple medical policies effective February 15, 2026, adding new prior authorization requirements for coronary CTA and bone density testing, while updating coverage criteria for amniotic membrane products, bioengineered skin substitutes, respiratory oscillatory devices, and sleep apnea surgeries.
Action Required
By February 15, 2026: Billing team must update system to require prior authorization for coronary CTA procedures and peripheral bone density testing (77081). Update encounter forms and staff training materials to reflect new preauthorization requirements. Verify coverage criteria for amniotic membrane treatments, bioengineered skin substitutes, respiratory devices, and hypoglossal nerve stimulation procedures. Claims submitted without required prior authorization will be denied.