CommercialBilling CodesHigh impact
Medical Policy Update July 1, 2026
Blue Cross NC·NC · Genetics, Oncology, Sleep Medicine +6 more·Medical Policy
Effective date
Jul 1, 2026
We identified it
Jul 1, 2026
Summary
Blue Cross NC has updated 13 medical policies effective July 1, 2026, adding 50+ new PLA and CPT codes across genetic testing, advanced diagnostics, and specialized procedures. The billing team must update claim submission systems and encounter documentation to recognize these new codes to avoid claim denials and ensure proper reimbursement.
Action Required
By June 30, 2026: Billing team must update claim submission system and EMR encounter templates to recognize and properly code all 40 new CPT/PLA codes listed in this policy update. For each policy domain (electromagnetic navigation bronchoscopy, genetic testing, laboratory procedures, liquid biopsy, MRD, pharmacogenetics, phrenic nerve stimulation, prenatal screening, skin/soft tissue substitutes, and targeted therapy testing), ensure providers select the correct new code during claim creation. Remove deleted code 0577U (Liquid Biopsy) from active billing lists and replace with new codes 0634U, 0640U, 0643U. Update denial prevention logic to accept these codes without unnecessary rejections. Failure to implement these changes will result in claim denials, processing delays, and revenue loss starting July 1, 2026.