Blue Cross NC policies, page 15

Search Blue Cross NC's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

1,022 public policies Substrate tracks for Blue Cross NC, by title.

Blue Cross NC policies
PolicyDetailsCodesSource
Place of Service NotificationEffective Jun 1, 2022—Original policy ↗
Plugs for Fistula RepairCommercial2Original policy ↗
Pneumatic Compression Device for Chest, Abdomen, Trunk, Head and/or Neck6Original policy ↗
Pneumatic Compression Pumps for Treatment of Lymphedema and Venous UlcersCommercial21Original policy ↗
Portable/Mobile/Handheld Radiology ServicesG-06160 · Effective Jul 23, 2021 · Medicaid—Original policy ↗
Positional Magnetic Resonance Imaging (MRI)Commercial1Original policy ↗
Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism ProphylaxisCommercial18Original policy ↗
Power Enhanced, Robotic Assisted and/or Microprocessor Upper and Lower Extremity Rehabilitative Devices (MyoPro/IpSiHand/Motus)Medicaid4Original policy ↗
Powered Exoskeleton for Ambulation in Patients with Lower Limb DisabilitiesCommercial2Original policy ↗
Pre-Implantation Genetic Testing AHS - M2039M2039 · Commercial83Original policy ↗
Pre-Operative Testing AHS – G2023G2023 · Commercial22Original policy ↗
Preadmission and Preoperative ServicesCommercial—Original policy ↗
Preadmission and Preoperative ServicesCommercial—Original policy ↗
Preadmission and Preoperative ServicesEffective Jan 1, 202612Original policy ↗
Preadmission Services for Inpatient StaysG-01017 · Effective Dec 11, 2023 · Medicaid—Original policy ↗
Precertification/Prior Authorization Requirement Changes Effective December 1, 2025NCBCBS-CR-089335-25-CPN88807 · Effective Dec 1, 2025 · Medicaid20Original policy ↗
Precertification/Prior Authorization Requirement Changes Effective January 1, 2026NCBCBS-CR-091801-25-CPN90708 · Effective Jan 1, 2026 · Medicaid6Original policy ↗
Prenatal Screening (Genetic) AHS - M2179M2179 · Commercial67Original policy ↗
Prenatal Screening (Genetic) AHS - M2179 NotificationM2179 · Commercial67Original policy ↗
Prenatal Screening (Genetic) AHS – M2179M2179 · Commercial54Original policy ↗
Prenatal Screening (Nongenetic) AHS - G2035G2035 · Commercial101Original policy ↗
Prenatal Screening (Nongenetic) AHS – G2035G2035 · Commercial88Original policy ↗
Prenatal Screening AHS – G2035G2035 · Commercial106Original policy ↗
Prenatal Screening for Fetal Aneuploidy AHS –G2055G2055 · Commercial24Original policy ↗
Prenatal Testing for Fetal Aneuploidy AHS - G2055G2055 · Commercial30Original policy ↗
Prescription Medication and Illicit Drug Testing in the Outpatient Setting AHS - T2015T2015 · Commercial33Original policy ↗
Prescription Medication and Illicit Drug Testing in the Outpatient Setting AHS – T2015T2015 · Commercial17Original policy ↗
Pressure Reducing Support SurfacesCommercial6Original policy ↗
Preventing Flu: Drive the Change Through Vaccination (PDF)NCBCBS-CR-083244-25-CPN83065 · Medicaid—Original policy ↗
Preventive Medicine and Sick Visits on the Same DayG-05016 · Effective May 22, 2024 · Medicaid—Original policy ↗
Pricing and Adjudication PrinciplesCommercial—Original policy ↗
Pricing and Adjudication PrinciplesCommercial—Original policy ↗
Pricing and Adjudication PrinciplesCommercial—Original policy ↗
Pricing and Adjudication Principles—Original policy ↗
Pricing and Adjudication Principles—Original policy ↗
Pricing and Adjudication PrinciplesEffective Jun 1, 2022—Original policy ↗
Pricing and Adjudication Principles—Original policy ↗
Pricing and Adjudication Principles—Original policy ↗
Prior Authorization Requirement Changes Effective December 1, 2024NCBCBS-CR-057220-24-CPN56904 · Effective Dec 1, 2024 · Medicaid54Original policy ↗
Prior Authorization Requirement Changes Effective February 1, 2025NCBCBS-CR-068212-24-CPN67511 · Effective Feb 1, 2025 · Medicaid13Original policy ↗
Prior Authorization Requirement Changes Effective January 1, 2025NCBCBS-CR-066978-24-CPN66375 · Effective Jan 1, 2025 · Medicaid25Original policy ↗
Prior Authorization Requirement Changes Effective July 1, 2025 (Additional changes) (PDF)NCBCBS-CR-077743-25-CPN77344 · Medicaid147Original policy ↗
Prior Authorization Requirement Changes Effective July 1, 2025 (PDF)NCBCBS-CR-076902-25-CPN76474 · Medicaid46Original policy ↗
Prior Authorization Requirement Changes Effective November 1, 2025 (PDF)NCBCBS-CR-084745-25-CPN84299 · Medicaid39Original policy ↗
Private Duty Nursing ServicesCommercial4Original policy ↗
Professional Anesthesia ServicesG-07018 · Effective Jan 1, 2021 · Medicaid—Original policy ↗
Professional Pathology Billing Requirements AHS – R2169R2169 · Commercial41Original policy ↗
Prolia Prior Authorization Criteria – Medicare Part D—Original policy ↗
Proof of Timely FilingG-06133 · Effective Nov 19, 2021 · Medicaid—Original policy ↗
Proprietary Laboratory Analyses (PLA) Codes Notification62Original policy ↗

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Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.