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2026 January Medical Policy Updates

BlueCross BlueShield of South Carolina·SC · Neurosurgery, Neurology, ENT (Ear, Nose & Throat) +18 more·Medical Policy
Effective date
Jan 1, 2026
We identified it
Aug 11, 2026
Days to comply

Summary

BlueCross BlueShield of South Carolina and BlueChoice HealthPlan released 35 updated medical policies effective January 2026, with the most critical changes being: (1) CPT code additions/deletions across multiple specialties effective 01/01/2026, (2) new investigational statements for Tibial Nerve Stimulation and Extracranial Carotid Artery Stenting, and (3) updated coverage denials for specific liver transplant indications. Most policies underwent annual reviews with no intent changes, but coding section updates require immediate billing system modifications.

Action Required

Action needed
By December 31, 2025: (1) BILLING TEAM must update billing software to DELETE the following codes effective 01/01/2026: 0275T, 0394T, 33884, 33889, 75956, 75957, 75958, 75959, 0421T, 0619T. (2) ADD the following new codes to system effective 01/01/2026: 62330, 62331, 77436, 77437, 77438, 77439, 33882, 35602, 0994T, 0995T, 52443, 52597, 87182, 87812, 0587T, 0588T, 0589T, 0590T. (3) CORRECT existing codes in CAM 152: change 0062T and 0063T to 0662T and 0663T. (4) UPDATE CAM 70306 (Liver Transplant) to denote as NOT MEDICALLY NECESSARY: unresectable colorectal liver metastases, hepatic epitheloid hemangiodenothelioma, hepatic adenomas, intrahepatic cholangiocarcinoma. (5) PROVIDERS must note new investigational statements in CAM 701106 (Tibial Nerve Stimulation for urge urinary incontinence) and CAM 70168 (Carotid angioplasty without stenting). (6) UPDATE encounter forms and clinical decision support in EHR to reflect new coverage criteria in CAM 40204 (Reproductive Techniques). Failure to update codes will result in claim denials or rejections on 01/01/2026 forward.

Affected Billing Codes

62330
62331
77436
77437
77438
77439
33882
35602
33884
33889
75956
75957
75958
75959
52443
52597
87182
87494
87812