2025 July Medical Policy Updates

REQUIREMENTS: By 01/01/2025 (retroactive - URGENT): - Billing team must add code C1735 to system for CAM 701136 (Radiofrequency Ablation of Renal Sympathetic Nerves). Update billing software claims validation and any templates referencing this procedure. Immediately (effective 07/29/2025): - Billing team must add codes Q4368, Q4369, Q4370, Q4371, Q4372, Q4373, Q4375, Q4376, Q4377, Q4378, Q4379, Q4380, and Q4382 to billing system for CAM 701149 (Amniotic Membrane and Amniotic Fluid Injections). Update charge master and procedure lookup tables. - Medical coding staff must review CAM 20219 (Catheter Ablation for Atrial Fibrillation) and update internal documentation regarding code 93656 verbiage changes effective 07/01/2025 (NOTE: This date has already passed; ensure system reflects current 93656 requirements immediately). - Billing team must update screening encounter forms and claim submission processes to use ICD-10 code Z1331 for anxiety and depression screenings per CAM 089 updates. Other actions: - Providers and clinical staff should review updated evidence summaries and rationale sections for affected procedures, particularly CAM 80161 (Focal Treatments for Prostate Cancer) and CAM 701118 (Surgical Treatment of Femoroacetabular Impingement) which have policy guideline clarifications. - Compliance team should verify that all policies are downloadable and accessible from www.SouthCarolinaBlues.com and www.BlueChoiceSC.com for provider reference. Consequences of inaction: Claims using new amniotic membrane codes or renal sympathetic nerve ablation without proper code updates will be denied or delayed. Incorrect screening codes will result in claim rejections and rework.