CommercialPrior AuthHigh impact
MPC March 2022
Blue Cross Blue Shield of Nebraska·NE · Oral & Maxillofacial Surgery, Plastic Surgery, Pulmonology +3 more·Medical Policy
Effective date
Jun 1, 2022
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Nebraska has implemented multiple policy changes effective between February and June 2022, including new orthognathic surgery criteria requiring preauthorization, updates to home ventilator requirements, and revised coverage for hyperbaric oxygen therapy, IMRT, rhinoplasty, and panniculectomy procedures.
Action Required
By June 1, 2022: Billing team must update prior authorization requirements for orthognathic surgery (III.243), subchondroplasty (III.242), and WATS3D procedures (V.79). Update billing system to flag these procedures for preauth. For home ventilators (E0466), ensure documentation includes failed BiPAP trial and qualifying diagnoses. For panniculectomy (15830), verify Grade 2+ panniculus documentation and failed conservative treatment records. Claims submitted without proper preauthorization will be denied.