All PlansCoverageHigh impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Pain Management, Orthopedics, Neurosurgery +1 more·Medical Policy
Effective date
Nov 15, 2026
We identified it
Sep 12, 2026
Summary
Arkansas Blue Cross is removing a previous non-coverage statement for steroid injections into facet joints, effectively reversing a blanket denial and making these procedures potentially coverable under Primary Coverage Criteria. Billing teams must immediately stop denying facet joint steroid injection claims based on the old non-coverage policy and begin processing them according to individual member benefit certificates and medical necessity determinations.
Action Required
By November 15, 2026: Billing team must update claim processing system to remove the automatic non-coverage denial rule for steroid injections into facet joints (Policy 1997248). Update billing software to flag these claims for medical necessity review on a per-member basis rather than automatic rejection. Providers should be notified that facet joint steroid injection claims will now be evaluated individually per member benefit certificate terms. For members whose contracts lack Primary Coverage Criteria, claims may still be denied as not medically necessary or investigational per their specific plan exclusions. Failure to update system rules will result in incorrectly denied claims that should be processed.