CommercialBilling CodesHigh impact
2026 March Medical Policy Updates
BlueCross BlueShield of South Carolina·SC · Cardiology, Endocrinology, Genetics +15 more·Medical Policy
Effective date
Mar 1, 2026
We identified it
Aug 20, 2026
Summary
BlueCross BlueShield of South Carolina and BlueChoice HealthPlan released 49 medical policy updates effective March 2026, with most being annual reviews that clarify language and update references without changing coverage intent. However, several policies contain substantive changes: CAM 20191 now covers gastric peroral endoscopic myotomy (G-POEM) for gastroparesis treatment; CAM 10130 adds hybrid closed loop insulin delivery systems; CAM 20104 expands hyperbaric oxygen therapy indications; CAM 126 changes vitamin D testing frequency; and CAM 256 removes primary C cell hyperplasia as an indication. Additionally, 8 policies add new CPT codes effective April 1, 2026 (0616U, 0620U, 0621U, 0630U, 0628U, 0617U, and updated coding for Lyme disease and transplant rejection testing).
Action Required
By April 1, 2026: Billing team must update claims processing system to recognize 10 new or updated CPT codes (0580U, 0615U, 0616U, 0620U, 0621U, 0630U, 0628U, 0617U, 0319U, 84207). Immediately: Clinical staff and providers must review substantive policy changes affecting coverage decisions—specifically CAM 20191 (G-POEM now covered for gastroparesis), CAM 10130 (hybrid closed loop insulin systems now covered), CAM 20104 (expanded hyperbaric oxygen therapy indications), CAM 126 (vitamin D testing limited to once per 6 months for symptomatic individuals), and CAM 256 (primary C cell hyperplasia indication removed from genetic testing). Update clinical guidelines and order entry templates to reflect new covered indications and testing frequency limits. Failure to implement coding updates by April 1 will result in claim denials for services using new codes. Providers must verify medical necessity aligns with updated coverage criteria to avoid denials.