Summary
Blue Cross and Blue Shield of Nebraska's MPC November 2026 update lists two policies effective 11/01/2026. New policy III.277 Evolent Joint Surgery (Hip, Knee, Shoulder Surgeries) applies to all employer groups and requires preauthorization, which Evolent performs. Revised policy I.200 Amniotic Membrane and Amniotic Fluid and I.202 Bioengineered Skin and Soft Tissue Substitutes adds codes 15271 through 15278 and also requires preauthorization.
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What to do
Action · 3 steps
01Already effective 2026-11-01: Billing team: For the Evolent Joint Surgery policy, Preauthorization Required is Yes and Evolent performs the preauthorizations, so submit the pre-service review for the listed joint surgery codes by calling toll free 1-866-972-9642 (7:00am to 7:00pm CST) or visiting www.RadMD.com.
02For the amniotic membrane and bioengineered skin and soft tissue substitute policy, Preauthorization Required is Yes, and codes 15271 through 15278 were added.
03Confirm current applicability of these policies, since their effective date is before the analysis date.
Codes mentioned
274862748727446274382757029884274052740727409274272742827429298882988927332273332740329868298802988129882298832741227415274162741827420274222742427425298662986729870298732987429875298762987729879298852988629887G02892347323474234722347029825234502345523460234622346523466298062980723410234122342029827231202312523130234052341523430237002980529819298202982129822298232982429826298281527115272152731527415275152761527715278
Original notice
MPC November 2026
nebraskablue.com · Always check the source before changing claims.
Related changes
See all Blue Cross Blue Shield of Nebraska changes →Medical Policy Updates Effective 11/01/2026HighEffective Nov 1, 2026 · Medical PolicyMPC November 2021MediumEffective Mar 1, 2022 · Medical PolicyMPC November 2021LowNo effective date · Medical PolicyMPC November 2022MediumEffective Jan 1, 2023 · Medical PolicyBrowse every Blue Cross Blue Shield of Nebraska change in the policy list
Related policy hubs
Blue Cross Blue Shield of Nebraska policiesNE policy changesOrthopedicsWound CareCode 27486Code 27487Code 27446Code 27438Code 27570Code 29884Code 27405Code 27407Code 27409Code 27427Code 27428Code 27429Code 29888Code 29889Code 27332Code 27333Code 27403Code 29868Code 29880Code 29881Code 29882Code 29883Code 27412Code 27415Code 27416Code 27418Code 27420Code 27422Code 27424Code 27425Code 29866Code 29867Code 29870Code 29873Code 29874Code 29875Code 29876Code 29877Code 29879Code 29885Code 29886Code 29887Code G0289Code 23473Code 23474Code 23472Code 23470Code 29825Code 23450Code 23455Code 23460Code 23462Code 23465Code 23466Code 29806Code 29807Code 23410Code 23412Code 23420Code 29827Code 23120Code 23125Code 23130Code 23405Code 23415Code 23430Code 23700Code 29805Code 29819Code 29820Code 29821Code 29822Code 29823Code 29824Code 29826Code 29828Code 15271Code 15272Code 15273Code 15274Code 15275Code 15276Code 15277Code 15278