Summary
This is a historical policy update from Blue Cross and Blue Shield of Nebraska (issued May 26, 2022, newly discovered October 10, 2026) containing multiple medical and pharmacy policy changes with staggered effective dates between June 1 and August 1, 2022. All changes are now past effective and already implemented; the billing team should verify current applicability rather than treat these as pending actions, as nearly 4 years have elapsed since publication.
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What to do
Action · 2 steps
01Already effective (August 1, 2022 and June 1, 2022): Verify whether the practice has implemented all policies outlined in this May 2022 update—including prior authorization requirements for prostate rectal spacers (SpaceOAR), spinal cord tethering, piriformis syndrome surgery, durable medical equipment blood ketone monitoring, and the pharmacy policies (Fyarro, Lutathera, Pluvicto, Enjaymo, Pyrukynd, and others with drug-specific clinical criteria)—and confirm current applicability with Blue Cross and Blue Shield of Nebraska, as this source material is historical and may have been superseded.
02Contact the payer directly or consult current policy documentation to ensure billing workflows reflect any subsequent updates issued between June 2022 and October 2026.
Original notice
MPC May 2022
nebraskablue.com · Always check the source before changing claims.
Related changes
See all Blue Cross Blue Shield of Nebraska changes →MPC November 2021MediumEffective Mar 1, 2022 · Medical PolicyMPC November 2021LowNo effective date · Medical PolicyMPC March 2022MediumNo effective date · Medical PolicyMPC March 2022MediumEffective Jul 1, 2022 · Medical PolicyBrowse every Blue Cross Blue Shield of Nebraska change in the policy list