CommercialPrior AuthHigh impact
MPC November 2021
Blue Cross Blue Shield of Nebraska·NE · Orthopedics, Urology, Ophthalmology +8 more·Medical Policy
Effective date
Mar 1, 2022
We identified it
Jun 24, 2026
Summary
Blue Cross Blue Shield of Nebraska implemented multiple prior authorization requirements and coverage changes effective March 1, 2022, including new prior auth for inpatient joint replacements and various specialized procedures across multiple specialties.
Action Required
By March 1, 2022: Billing teams must update systems to require prior authorization for all inpatient hip, knee, and shoulder arthroplasty procedures, BPH treatments (Urolift), intravitreal corticosteroid implants, genetic testing panels, ECT, DME, and other specified procedures. Update encounter forms to remind providers of new prior auth requirements. Verify authorization before scheduling inpatient joint procedures to avoid claim denials.