CommercialBilling CodesHigh impact
2025 October Medical Policy Updates
BlueCross BlueShield of South Carolina·SC · Oncology, Neurosurgery, Dermatology +10 more·Medical Policy
Effective date
Oct 1, 2025
We identified it
Aug 20, 2026
Summary
BlueCross BlueShield of South Carolina and BlueChoice HealthPlan released October 2025 medical policy updates affecting 50+ policies. Key changes include: three NEW spine surgery policies (CAM 401, 400, 399), addition of 10+ new billing codes across cancer genomics and diagnostic testing (0590U, 0593U, 0597U, 0591U, 0578U, 0577U, 0592U, 0598U, 83884, 87626, 83630, 83993), expanded coverage for pathogen panel testing in immunocompromised members, and coverage expansions for fecal calprotectin and liver fibrosis testing. Most changes are effective 10/01/2025; majority are annual reviews with no policy intent changes but updated documentation/references.
Action Required
By October 1, 2025: Billing team must immediately update claims processing and billing software to recognize 10 newly added CPT/HCPCS codes (0590U, 0593U, 0597U, 0591U, 0578U, 0577U, 0592U, 0598U, 83884, 87626, 83630, 83993) and new HCPCS code E0659 for lymphedema pumps. Remove obsolete codes from fee schedules (87040, 0500T, 81376, 81377, 81382, 81383, 88341, 88342). Implement three new spine surgery policies (CAM 401, 400, 399) in prior authorization system—these require immediate setup. Update EMR/billing templates to reflect expanded coverage for fecal calprotectin (CAM 318), liver fibrosis markers (CAM 332), and expanded pathogen panel testing for immunocompromised patients (CAM 181). Update CPT 90679, 90683, 90678 benefit limits to age 75+; add CPT 90382 for neonates in CAM 109. Coding/Billing team must train staff on new codes and update modifier/coverage rules. Providers must update encounter forms to reflect expanded testing options. Failure to implement code additions by 10/01/2025 will result in claim denials; failure to remove obsolete codes may cause system rejections.