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Arkansas Blue Cross Blue ShieldAll Plans · Coverage · Medical Policy · AR · Pain Management, Orthopedics, Neurosurgery +1 moreHigh impact

Policy Criteria Change

Act
by Nov 15, 2026
Effective date
Nov 15, 2026
Identified
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.

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What to do

by Nov 15, 2026 · 4 steps
01Billing team must update claim processing system to remove the automatic non-coverage denial rule for steroid injections into facet joints (Policy 1997248).
02Update billing software to flag these claims for medical necessity review on a per-member basis rather than automatic rejection.
03Providers should be notified that facet joint steroid injection claims will now be evaluated individually per member benefit certificate terms.
04For members whose contracts lack Primary Coverage Criteria, claims may still be denied as not medically necessary or investigational per their specific plan exclusions.
If missed: Failure to update system rules will result in incorrectly denied claims that should be processed.

Original notice

Policy Criteria Change
assets.contentstack.io · Always check the source before changing claims.
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Related changes

See all Arkansas Blue Cross Blue Shield changes →
Policy Criteria ChangeHighEffective Oct 28, 2026 · Medical PolicyPolicy Criteria ChangeMediumEffective Nov 15, 2026 · Medical PolicyPolicy Criteria ChangeHighEffective Oct 7, 2026 · Medical PolicyPolicy Criteria ChangeHighEffective Sep 24, 2026 · Medical PolicyBrowse every Arkansas Blue Cross Blue Shield change in the policy list

Related policy hubs

Arkansas Blue Cross Blue Shield policiesAR policy changesPain ManagementOrthopedicsNeurosurgerySports Medicine

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