Summary
BlueCross BlueShield of South Carolina's June 2025 medical policy update added or revised Category III lab codes effective July 1, 2025, and made smaller coding and coverage changes to anesthesia qualifying-circumstance codes, genetic testing policies and preimplantation genetic testing. Because the bulletin is dated 2025, these changes are historical, and several code additions have no effective date stated in the source.
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What to do
Action · 9 steps
01Historical material (the bulletin is dated 2025, and the Category III lab codes took effect July 1, 2025, so they are already in effect): Lab billing and charge entry staff should confirm that the codes added or revised for July 1, 2025 (0220U, 0522U, 0573U, 0560U, 0561U, 0569U, 0567U, 0420U, 0557U, 0562U, 0565U, 0566U, 0285U, 0393U, 0568U, 0574U, 0571U) are in charge entry with the revised descriptions, and that the tests are documented against the criteria in their cited BCBS SC policies.
02Anesthesia billing staff should note that the anesthesia policy (CAM 012) states the qualifying circumstance codes 99100, 99116, 99135 and 99140 and the risk factor modifiers P3, P4 and P5 are reimbursable only when billed with the AA or QZ modifier; add those modifiers in charge entry and claim edits.
03The bulletin does not state an effective date for this statement, so check the current CAM 012 text.
04Genetic testing staff should add 81403 and 81479 (CAM 281) and 81415, 81416, 81425 and 81426 (CAM 266) only where the cited policy criteria are documented; CAM 266 requires genetic counseling for epilepsy genetic testing.
05Fertility and ob-gyn staff should review the preimplantation genetic testing codes 89290 and 89291 (CAM 40204), which the policy covers for monogenic and single gene diseases.
06Ob-gyn staff should review code A9293 (CAM 094), which the bulletin adds for an FDA-approved contraception mobile application.
07The bulletin does not state effective dates for several additions, so do not assume a date.
08Because this bulletin is historical, check the current version of each cited BCBS SC policy before relying on it.
09Other annual reviews in the bulletin, with no change in policy intent, need no billing change.
Codes mentioned
A9293814158141681425814268140381479991009911699135991408929089291
Original notice
2025 June Medical Policy Updates
southcarolinablues.com · Always check the source before changing claims.
Related changes
See all BlueCross BlueShield of South Carolina changes →2025 August Medical Policy UpdatesMediumEffective Oct 1, 2025 · Medical Policy2026 August Medical Policy UpdatesMediumNo effective date · Medical Policy2026 July Medical Policy UpdatesHighEffective Jul 1, 2026 · Medical Policy2026 June Medical Policy UpdatesMediumNo effective date · Medical PolicyBrowse every BlueCross BlueShield of South Carolina change in the policy list