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CommercialCoverageMedium impact

Policy Criteria Changes

Arkansas Blue Cross Blue Shield·AR · Neurology, Cardiology, Cardiothoracic Surgery +1 more·Medical Policy
Effective date
Nov 15, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

Arkansas Blue Cross updated coverage criteria for two areas: added coverage for Viltolarsen (Viltepso) for Duchenne Muscular Dystrophy patients aged 4-9, and revised criteria for Coronary CT Angiography (CCTA) with specific new indications for abnormal exercise tests and preoperative cardiac evaluation.

Action Required

Action needed
Before November 15, 2025: Billing team must update prior authorization criteria for Viltolarsen (Viltepso) to include patients aged 4-9 with Duchenne Muscular Dystrophy. Update CCTA billing requirements to ensure documentation supports new coverage criteria including abnormal exercise treadmill tests and preoperative cardiac evaluation scenarios. Review encounter forms to capture required criteria documentation.