CommercialPrior AuthHigh impact
MPC December 2022
Blue Cross Blue Shield of Nebraska·NE · Vascular Surgery, Cardiology, Orthopedics +3 more·Medical Policy
Effective date
Dec 1, 2022
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Nebraska is implementing multiple new policies effective March 1, 2023, requiring preauthorization for varicose vein procedures, cardiac ablation, stem cell therapy, vitamin D testing, and cooling devices. Three new pharmacy policies for Skysona, Zynteglo, and Ztalmy are effective immediately (December 1, 2022).
Action Required
By March 1, 2023: Billing team must update system to require prior authorization for all varicose vein procedures, cardiac ablation procedures, stem cell therapy, vitamin D testing (limit 2 tests per year), and cooling devices (codes E0218, E0236, E0217, E0676). Immediately: Obtain prior authorization for Skysona, Zynteglo, and Ztalmy prescriptions. Update encounter forms and alert providers that claims will be denied without proper preauthorization.