CommercialPrior AuthHigh impact
MPC March 2022
Blue Cross Blue Shield of Nebraska·NE · Oral & Maxillofacial Surgery, Orthopedics, Pulmonology +4 more·Medical Policy
Effective date
Jun 1, 2022
We identified it
Jun 24, 2026
Summary
Blue Cross Blue Shield of Nebraska updated multiple medical policies effective between February and June 2022, including new orthognathic surgery criteria requiring preauthorization, new investigational procedures (subchondroplasty, WATS3D), revised home ventilator policies, expanded hyperbaric oxygen therapy for diabetic foot ulcers, updated IMRT criteria for lung cancer, and revised rhinoplasty/panniculectomy requirements.
Action Required
By June 1, 2022: Billing team must update prior authorization requirements for orthognathic surgery, subchondroplasty, and WATS3D procedures. Update billing system to flag these as requiring preauth. For rhinoplasty and panniculectomy cases, ensure proper documentation criteria are met before submission. Add diabetic foot ulcers as covered indication for hyperbaric oxygen therapy. Claims without proper preauthorization will be denied.