CommercialPrior AuthMedium impact
MPC February 2023
Blue Cross Blue Shield of Nebraska·NE · PM&R (Physical Medicine & Rehab), Pain Management, Cardiology +4 more·Medical Policy
Effective date
May 1, 2023
We identified it
Jun 24, 2026
Summary
Blue Cross Blue Shield of Nebraska is implementing several new medical policies effective May 1, 2023, requiring prior authorization for myoelectric upper limb prosthetics, sympathetic nerve blocks, transcatheter aortic valve replacement, and ICD interrogation. New pharmacy policies for specialized drugs like Hemgenix and Relyvrio also require prior authorization starting March 1, 2023.
Action Required
Before May 1, 2023: Billing team must update prior authorization requirements in system for myoelectric upper limb prosthetics, sympathetic nerve blocks, transcatheter aortic valve replacement, and ICD interrogation procedures. Before March 1, 2023: Add prior authorization requirements for new pharmacy policies including Hemgenix, Relyvrio, Tzield, and Furoscix. Update encounter forms and alert providers that claims will be denied without proper prior authorization.