CommercialCoverageMedium impact
Medical Policies Updates
Blue Cross Blue Shield of North Dakota·ND · Urology, Orthopedics, PM&R (Physical Medicine & Rehab) +1 more·Provider News
Effective date
Jul 1, 2025
We identified it
Jun 19, 2026
Summary
BCBSND has updated multiple medical policies effective July 1, 2025, including new Category III T-Codes and PENFS policies, revised male sexual dysfunction coverage (making penile contracture devices experimental), and coding changes for wheelchairs and male sexual dysfunction treatments. Several policies have also been moved to consent-based coverage.
Action Required
By July 1, 2025: Billing team must update system to reflect E0201 (penile implant pump) as experimental/investigational and verify prior authorization requirements. Add E2298 to covered wheelchair codes in billing software. Review new Category III T-Codes policy and PENFS policy on BCBSND website for any applicable procedures. Update encounter forms to reflect consent policy requirements for ultrasound osteogenesis stimulators, AposTherapy systems, and confocal laser endomicroscopy.