CommercialPrior AuthHigh impact
MPC February 2024
Blue Cross Blue Shield of Nebraska·NE · Pain Management, Neurology, Plastic Surgery +3 more·Medical Policy
Effective date
Jun 1, 2024
We identified it
Jun 24, 2026
Summary
Blue Cross Blue Shield of Nebraska updated multiple medical policies effective June 1, 2024, adding prior authorization requirements and age restrictions for Botox treatments, restricting lymphedema procedures, adding radiology codes, and retiring contact lens coverage for specific conditions.
Action Required
By June 1, 2024: Billing team must update system to require prior authorization for sympathetic nerve blocks, Botox injections (J0585, J0588, J0586), lymphedema treatments, and CT angiography (74175). Update encounter forms with new FDA age limits for Botox procedures. Stop billing contact lens coverage for bullous keratopathy, corneal ulcers, and related diagnoses. Update lumbar disc replacement codes to be reviewed under pain management policy III.187.