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Blue Cross Blue Shield of North DakotaCommercial · Billing Codes · Provider News · ND · Orthopedics, Neurology, Ophthalmology +5 moreHigh impact

Medical Policies Updates

Effective date
Jan 1, 2026
Identified
Jun 19, 2026

Summary

The following medical policies take effect Jan. 1, 2026: new policies for Aqueous Shunts and Stents for Glaucoma, Computerized Corneal Topography, Renal Denervation System, Skin Substitutes, Supplementary Algorithm for Cardiac Magnetic Resonance Imaging, and Fibrin Sealant, along with revised policies including Patient Lifts, Biofeedback, Intensity-Modulated Radiotherapy, and Electrical Nerve Stimulation. Coding changes effective Oct. 1, 2025 added new codes E0150, A9288, L1007, and A9616 for their listed services, and many policies removed G35 from covered diagnosis codes and added G35.A, G35.B0, G35.B1, G35.B2, G35.C0, G35.C1, G35.C2, and G35.D. Cervical Fusions, Corneal Topography, Amniotic Membrane and Amniotic Fluid, and Bioengineered Skin and Soft Tissue Substitutes policies will be archived or retired.

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What to do

Action · 7 steps
01Already effective Oct.
021, 2025 for the coding changes that carry that date, including the new codes E0150, A9288, L1007, and A9616, so check current applicability.
03Effective Jan.
041, 2026: Billing team should check the medical policy in effect at the time of service for the new and revised policies listed above, because the source states that benefit determinations are made based on the medical policy in effect at the time of service.
05For apheresis claims under CPT 36511, 36512, 36513, 36514, 36516, and S2120, use E78.010, E78.011, and E78.019 and stop using E78.01 on the covered diagnosis codes.
06For CPT 36522 and the other policies that listed the change, replace G35 with G35.A, G35.B0, G35.B1, G35.B2, G35.C0, G35.C1, G35.C2, and G35.D on the covered diagnosis codes, including Electroencephalogram, Wheelchairs and Options/Accessories, Seat Lift Mechanisms, High Frequency Chest Wall Oscillation Devices, Foot Care Services, Physical Therapy, and Chelation Therapy.
07Billing team should also check the Experimental/Investigational removed termed procedure codes list and the Category III T code changes in the coding section before billing those codes.

Codes mentioned

E0150A9288L1007A9616L6975E0658E0659L5657A2036A2037A2038A2039E0691270009700197002365113651236513365143651636522S212095004950179501895024950279502895076950793162631627C9728C9734C1739A4648C9751G35G35.AG35.B0G35.B1G35.B2G35.C0G35.C1G35.C2G35.DE78.01E78.010E78.011E78.019D71.1G0127G0245G0246S0390110551105611057117191172011721S9476S0157S9055C34.00C34.30C34.80C34.90R91.8

Original notice

Medical Policies Updates
bcbsnd.com · Always check the source before changing claims.
View original ↗

Related changes

See all Blue Cross Blue Shield of North Dakota changes →
Pharmacy Policy UpdatesMediumEffective Feb 10, 2026 · PharmacyPharmacy Policies Available OnlineMediumEffective Mar 17, 2026 · PharmacyMedical Policy Updates for Non-Migrated MembersHighNo effective date · Medical PolicyPharmacy Policy UpdatesMediumEffective May 12, 2026 · PharmacyBrowse every Blue Cross Blue Shield of North Dakota change in the policy list

Related policy hubs

Blue Cross Blue Shield of North Dakota policiesND policy changesOrthopedicsNeurologyOphthalmologyCardiologyPulmonologyENT (Ear, Nose & Throat)Wound CareOncologyCode E0150Code A9288Code L1007Code A9616Code L6975Code E0658Code E0659Code L5657Code A2036Code A2037Code A2038Code A2039Code E0691Code 27000Code 97001Code 97002Code 36511Code 36512Code 36513Code 36514Code 36516Code 36522Code S2120Code 95004Code 95017Code 95018Code 95024Code 95027Code 95028Code 95076Code 95079Code 31626Code 31627Code C9728Code C9734Code C1739Code A4648Code C9751Code G35Code G35.ACode G35.B0Code G35.B1Code G35.B2Code G35.C0Code G35.C1Code G35.C2Code G35.DCode E78.01Code E78.010Code E78.011Code E78.019Code D71.1Code G0127Code G0245Code G0246Code S0390Code 11055Code 11056Code 11057Code 11719Code 11720Code 11721Code S9476Code S0157Code S9055Code C34.00Code C34.30Code C34.80Code C34.90Code R91.8

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