CommercialCoverageMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Wound Care, Dermatology, Vascular Surgery +2 more·Medical Policy
Effective date
Oct 15, 2025
We identified it
Jun 19, 2026
Summary
Effective October 15, 2025, Arkansas Blue Cross will provide restricted coverage for non-pneumatic compression pumps used to treat lymphedema. Five HCPCS codes (E0681, E0678, E0679, E0680, E0682) are moving from non-covered status to restricted coverage under specific policy criteria.
Action Required
By October 15, 2025: Billing team must update system to allow billing of HCPCS codes E0681, E0678, E0679, E0680, E0682 for non-pneumatic compression pumps with restricted coverage requirements. Review complete policy 2010038 at provided link to understand coverage criteria. Update encounter forms to remind providers of documentation requirements for lymphedema treatment.