CommercialPrior AuthHigh impact
MPC January 2026
Blue Cross Blue Shield of Nebraska·NE · Plastic Surgery, General Surgery, Dermatology +2 more·Medical Policy
Effective date
May 1, 2026
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Nebraska is implementing a new medical policy requiring preauthorization for all tissue transfer (flap) procedures starting May 1, 2026. The policy covers 33 specific CPT codes and will use Interqual criteria for approval decisions.
Action Required
Before May 1, 2026: Billing team must update practice management system to require prior authorization for all 33 tissue transfer/flap CPT codes listed in the policy. Update encounter forms and scheduling workflows to alert staff when these procedures are planned. Train front desk staff to obtain preauthorization before scheduling these procedures for BCBS Nebraska patients. Failure to obtain prior authorization will result in claim denials.