CommercialPrior AuthHigh impact
MPC December 2022
Blue Cross Blue Shield of Nebraska·NE · Vascular Surgery, Cardiology, Orthopedics +2 more·Medical Policy
Effective date
Mar 1, 2023
We identified it
Jun 24, 2026
Summary
Blue Cross Blue Shield of Nebraska is implementing multiple policy changes effective March 1, 2023, requiring new prior authorizations for varicose vein procedures and cardiac ablation treatments, along with updates to stem cell therapy coverage criteria. Three new pharmacy policies for Skysona, Zynteglo, and Ztalmy are effective immediately and require prior authorization.
Action Required
By March 1, 2023: Update billing system to require prior authorization for all varicose vein procedures and cardiac ablation treatments. Immediately obtain prior authorization for Skysona, Zynteglo, and Ztalmy prescriptions. Update encounter forms and EMR templates to include prior auth requirements. Review stem cell therapy claims to ensure compliance with new investigational determinations for allograft bone products and cooling devices.