CommercialPrior AuthHigh impact
MPC November 2022
Blue Cross Blue Shield of Nebraska·NE · Neurosurgery, Orthopedics, Oncology +2 more·Medical Policy
Effective date
Jan 1, 2023
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Nebraska updated multiple medical policies effective January 1, 2023, adding new prior authorization requirements and coverage criteria for computer-assisted surgical navigation, oncology genetic testing, and various hereditary cancer susceptibility panels.
Action Required
Before January 1, 2023: Billing team must update prior authorization workflows for all listed CPT and HCPCS codes. Update billing software to flag these codes for required preauthorization. Train providers on new medical necessity criteria for genetic testing panels and oncology algorithmic tests. Verify patient eligibility meets specific diagnostic criteria before scheduling procedures. Claims submitted without proper prior authorization will be denied.