All PlansCoverageMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · General Surgery, Endocrinology, Gastroenterology +2 more·Medical Policy
Effective date
Oct 15, 2025
We identified it
Jun 19, 2026
Summary
Two policy changes effective October 15, 2025: folate testing will be covered for bariatric procedure patients, and when CRP and ESR are ordered together, only CRP will be approved.
Action Required
By October 15, 2025: Billing team must update system to allow folate testing claims for patients with bariatric procedures (Roux-en-Y gastric bypass, sleeve gastrectomy, biliopancreatic diversion/duodenal switch). Update lab ordering protocols to automatically exclude ESR when both CRP and ESR are ordered simultaneously - only CRP will be approved for payment. Inform providers of the CRP/ESR restriction to prevent claim denials.