2025 July Medical Policy Updates

REQUIREMENTS: 1. By 01/01/2025: Billing team must update billing system to recognize and allow code C1735 for radiofrequency ablation of renal sympathetic nerves (CAM 701136). Update encounter forms and clinical documentation templates. 2. Effective immediately (as of 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 amniotic membrane and amniotic fluid injections (CAM 701149). Update charge descriptions and clinical templates. 3. By 07/01/2025: Billing team must update code 93656 verbiage in billing system per CAM 20219 (catheter ablation for atrial fibrillation). Obtain full policy documentation from BlueCross BlueShield to confirm exact verbiage changes required. 4. Effective immediately: Update preventive screening encounter forms and billing rules to use ICD-10 code Z1331 (instead of previous code) for anxiety and depression screening (CAM 089). This applies to non-grandfathered PPACA plans. 5. Before 08/31/2025: Compliance team should download and review the complete text of all 40+ updated policies from www.SouthCarolinaBlues.com and www.BlueChoiceSC.com, particularly policies with substantive updates (CAM 701118, CAM 20184, CAM 20180, CAM 20198, CAM 80161). Flag any changes to policy guidelines, medical necessity criteria, or coverage limitations that may affect claim approval rates. CONSEQUENCES: Claims billed with outdated codes or incorrect coding sequences may be denied or delayed. Failure to update Z1331 coding may result in preventive service claims being improperly categorized.