CommercialCoverageMedium impact
Policy Criteria Changes
Arkansas Blue Cross Blue Shield·AR · OB-GYN, Family Medicine, Internal Medicine +2 more·Medical Policy
Effective date
Nov 24, 2025
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross implemented coding changes affecting three medical policies: prenatal screening codes 81001-86762 are no longer covered with pregnancy test diagnosis Z32.01, urine culture codes 87077-87186 are not covered with urge incontinence diagnosis N39.41, and thyroid testing is restricted for asymptomatic non-pregnant individuals during general exams.
Action Required
Before November 24, 2025: Billing team must update system edits to prevent billing CPT codes 81001, 81002, 81003, 81007, 81015, 87081, 87088, 86762 with diagnosis Z32.01, and codes 87077, 87140, 87147, 87149, 87181, 87186 with diagnosis N39.41. Update thyroid testing protocols to require documented symptoms for non-pregnant patients. Train providers on new coverage restrictions to prevent claim denials.