Summary
Blue Cross Blue Shield of Nebraska is implementing multiple policy changes effective June 1, 2024, including new preauthorization requirements for sympathetic nerve blocks, Botox/neurotoxin injections with FDA age restrictions, lymphedema treatments, and radiology procedures. Several policies are being retired including contact lens coverage for specific conditions and lumbar artificial disc procedures being moved to a different policy.
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What to do
by Jun 1, 2024 · 5 steps
01Billing team must update system to require preauthorization for sympathetic nerve blocks, Botox/neurotoxin injections (J0585, J0588, J0586), lymphedema treatments, and CT angiography abdomen (74175).
02Verify patient ages meet FDA requirements for Botox treatments before billing.
03Stop billing contact lens claims for bullous keratopathy, corneal ulcers, erosions, Stevens-Johnson syndrome, corneal transplants, Fuchs' dystrophy, and keratoconus as these will no longer be covered.
04For lumbar artificial disc codes (0164T, 0165T, 22857, 22860, 22862, 22865), follow Medical Policy III.187 criteria instead.
05Claims without proper preauthorization will be denied.
Codes mentioned
J0585J0588J05867417522857228602286222865
Original notice
MPC February 2024
nebraskablue.com · Always check the source before changing claims.
Related changes
See all Blue Cross Blue Shield of Nebraska changes →MPC February 2024HighEffective Jun 1, 2024 · Medical PolicyMPC February 2023LowNo effective date · Medical PolicyMPC February 2026MediumEffective Jun 1, 2026 · Medical PolicyMPC February 2023HighEffective May 1, 2023 · Medical PolicyBrowse every Blue Cross Blue Shield of Nebraska change in the policy list