Blue Cross NC policy
Supplemental Guide
Supplemental Guide is a public Blue Cross NC policy (policy U37164). It lists 26 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
View the original policy (PDF) ↗
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- Payer
- Blue Cross NC
- Policy number
- U37164
- Line of business
- Medicaid
- Source
- www.bcbsnc.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Open official prior authorization lists to check the member’s product.
| Code | Other Blue Cross NC policies |
|---|---|
| 36415 | Policies naming 36415 |
| 95004 | Policies naming 95004 |
| 95044 | Policies naming 95044 |
| 95060 | Policies naming 95060 |
| 95070 | Policies naming 95070 |
| 95115 | Policies naming 95115 |
| 95180 | Policies naming 95180 |
| 99202 | Policies naming 99202 |
| 99205 | Policies naming 99205 |
| 99211 | Policies naming 99211 |
| 99215 | Policies naming 99215 |
| 99381 | Policies naming 99381 |
| 99384 | Policies naming 99384 |
| 99385 | Policies naming 99385 |
| 99387 | Policies naming 99387 |
| 99391 | Policies naming 99391 |
| 99394 | Policies naming 99394 |
| 99395 | Policies naming 99395 |
| 99397 | Policies naming 99397 |
| E1399 | Policies naming E1399 |
| G0377 | Policies naming G0377 |
| G0402 | Policies naming G0402 |
| G0438 | Policies naming G0438 |
| G0439 | Policies naming G0439 |
| J0190 | Policies naming J0190 |
| J1563 | Policies naming J1563 |
All Blue Cross NC policies · Blue Cross NC prior authorization CPT list