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.
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What to do
by Jun 1, 2022 · 5 steps
01Billing team must update prior authorization requirements for orthognathic surgery (III.243), subchondroplasty (III.242), and WATS3D procedures (V.79).
02Update billing system to flag these procedures for preauth.
03For home ventilators (E0466), ensure documentation includes failed BiPAP trial and qualifying diagnoses.
04For panniculectomy (15830), verify Grade 2+ panniculus documentation and failed conservative treatment records.
05Claims submitted without proper preauthorization will be denied.
Codes mentioned
15830E0466
Original notice
MPC March 2022
nebraskablue.com · Always check the source before changing claims.
Related changes
See all Blue Cross Blue Shield of Nebraska changes →MPC March 2022MediumNo effective date · Medical PolicyMPC March 2022MediumEffective Jul 1, 2022 · Medical PolicyMPC March 2026MediumEffective Jul 1, 2026 · Medical PolicyMPC November 2021HighEffective Mar 1, 2022 · Medical PolicyBrowse every Blue Cross Blue Shield of Nebraska change in the policy list