CommercialPrior AuthMedium impact
MPC May 2024
Blue Cross Blue Shield of Nebraska·NE · PM&R (Physical Medicine & Rehab), Physical Therapy, Vascular Surgery +2 more·Medical Policy
Effective date
Sep 1, 2024
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Nebraska is implementing new medical policies for pneumatic pumps and revising electrical stimulation policies, both requiring preauthorization starting September 1, 2024. The pneumatic pump policy establishes specific coverage criteria for lymphedema treatment, while the electrical stimulation policy adds that subcutaneous tibial nerve stimulation is now considered investigational.
Action Required
Before September 1, 2024: Billing team must update prior authorization requirements for pneumatic pumps (programmable and nonprogrammable) and electrical stimulation procedures in billing system. Staff must verify coverage criteria for lymphedema pumps including specific diagnoses and documentation requirements for programmable pumps. Update encounter forms to remind providers that subcutaneous tibial nerve stimulation is now investigational and may not be covered.