CommercialPrior AuthHigh impact
MPC August 2022
Blue Cross Blue Shield of Nebraska·NE · Urology, OB-GYN, Pain Management +5 more·Medical Policy
Effective date
Aug 17, 2022
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Nebraska updated multiple medical policies requiring preauthorization for prostate MRI screening, uterine fibroid treatments, spinal cord stimulators, and several new pharmacy products. All policies require preauthorization with specific clinical criteria that must be met for coverage approval.
Action Required
By August 17, 2022: Billing team must update prior authorization workflows for prostate MRI screening, radiofrequency ablation for uterine fibroids, spinal cord stimulators for peripheral diabetic neuropathy, and new pharmacy products (Norliqva, Tavneos, Livtencity, Camzyos, Oxbryta). Update encounter forms to remind providers of new clinical criteria requirements. Providers must document specific age ranges, PSA levels, and clinical symptoms as outlined in each policy. Claims submitted without proper preauthorization will be denied.