Skeletal Remodeling (BSC7.21)

By July 15, 2026: Billing team must implement claim denial protocols for the following procedures when submitted to Blue Shield of California: rib remodeling procedures (WASP, RIBOSS, RibXcar, UUAIST, floating rib resection), clavicle shortening for body contouring, and scapular shaving/contouring for aesthetic/gender affirmation purposes. Update billing software and encounter templates to flag these as non-covered investigational or not medically necessary services. Providers must document medical necessity if procedures are performed for trauma, congenital deformity with functional impairment, reconstruction following medically necessary surgery, or tumor resection—these exceptions are reviewed under standard orthopedic policies. Train front desk and coding staff to identify these procedures and route claims appropriately. Communicate with providers that cosmetic skeletal remodeling procedures will be denied by Blue Shield; patients should be informed of non-coverage status and potential out-of-pocket costs before scheduling.