Summary
Blue Cross Blue Shield of Nebraska is implementing several new medical policies effective May 1, 2023, requiring prior authorization for myoelectric upper limb prostheses, sympathetic nerve blocks, transcatheter aortic valve replacement, and ICD interrogations. Additionally, new pharmacy policies for specialized medications including Hemgenix, Relyvrio, and Tzield will require prior authorization starting March 1, 2023.
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What to do
Action · 4 steps
01Before May 1, 2023: Billing team must update prior authorization requirements in billing system for myoelectric upper limb prostheses, sympathetic nerve blocks, transcatheter aortic valve replacement, and ICD interrogations.
02Before March 1, 2023: Add prior authorization requirements for new medications Hemgenix, Relyvrio, Leqembi, Tzield, and Furoscix.
03Update encounter forms and EMR templates to remind providers of new preauthorization requirements.
04Claims submitted without required prior authorization will be denied.
Original notice
MPC February 2023
nebraskablue.com · Always check the source before changing claims.
Related changes
See all Blue Cross Blue Shield of Nebraska changes →MPC February 2023LowNo effective date · Medical PolicyMPC February 2024HighEffective Jun 1, 2024 · Medical PolicyMPC February 2026MediumEffective Jun 1, 2026 · Medical PolicyMPC November 2021HighEffective Mar 1, 2022 · Medical PolicyBrowse every Blue Cross Blue Shield of Nebraska change in the policy list