Blue Cross NC policies, page 16

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
Prostate Biopsies AHS – G2007G2007 · Commercial2Original policy ↗
Prostate Biopsy Specimen Analysis AHS – G2007G2007 · Commercial9Original policy ↗
Prostate Specific Antigen (PSA) Testing AHS - G2008G2008 · Commercial9Original policy ↗
Prostatic Urethral LiftCommercial4Original policy ↗
Prosthetic and Orthotic DevicesG-06084 · Effective Oct 14, 2024 · Medicaid—Original policy ↗
Proteogenomic Testing of Individuals with Cancer AHS - M2168M2168 · Commercial20Original policy ↗
Proton Beam TherapyCommercial5Original policy ↗
Proton Beam Therapy4Original policy ↗
Proton Beam Therapy4Original policy ↗
Provider Manual (PDF)NCBCBS-CR-PM-065798-24 · Medicaid—Original policy ↗
Provider Performance Analytics Core Methodology (PDF)Commercial—Original policy ↗
Provider Preventable ConditionsG-20003 · Effective Mar 22, 2023 · Medicaid—Original policy ↗
Psychiatric Intensive Outpatient ProgramsCommercial1Original policy ↗
Psychiatric Intensive Outpatient ProgramsCommercial1Original policy ↗
Psychiatric Partial Hospitalization ProgramsCommercial1Original policy ↗
Psychiatric Partial Hospitalization ProgramsCommercial1Original policy ↗
Pulmonary DiseaseCommercial—Original policy ↗
Pulmonary Hypertension – Adempas Prior Authorization (with Quantity Limit) Criteria - Medicare Part D—Original policy ↗
Pulmonary Hypertension – tadalafil 20 mg and sildenafil 20 mg Prior Authorization (with Quantity Limit) Criteria - Medicare Part D—Original policy ↗
Pulmonary Hypertension – Uptravi Prior Authorization (with Quantity Limit) Criteria - Medicare Part D—Original policy ↗
PureWick Urine Collection System and External Urine Incontinence Suction Pumps4Original policy ↗
PureWick Urine Collection System and External Urine Incontinence Suction Pumps4Original policy ↗
Pyrimethamine Prior Authorization Criteria - Medicare Part D—Original policy ↗
Quantitative ElectroencephalographyCommercial8Original policy ↗
Quantitative Electroencephalography NotificationCommercial8Original policy ↗
Quantitative Sensory TestingCommercial9Original policy ↗
Quantitative Sensory TestingCommercial9Original policy ↗
Quantose Impaired Glucose Tolerance (IGT) Test AHS - G2135G2135 · Commercial2Original policy ↗
Quinine Sulfate Prior Authorization Criteria - Medicare Part D—Original policy ↗
Radiation Therapy ServicesCommercial31Original policy ↗
Radiation Therapy ServicesCommercial28Original policy ↗
Radioembolization for Primary and Metastatic Tumors of the LiverCommercial10Original policy ↗
Radiology Reductions for Technology TypeCommercial—Original policy ↗
Radiology Reductions for Technology TypeCommercial—Original policy ↗
Radiology Services Reimbursement PolicyCommercial27Original policy ↗
Radiosurgery, Stereotactic ApproachCommercial65Original policy ↗
Real-Time Prescription BenefitNCBCBS-CR-065102-24-CPN64484 · Medicaid—Original policy ↗
Reconstructive Eyelid Surgery and Brow LiftCommercial20Original policy ↗
Red Blood Cell Molecular Testing AHS - M2170AHS-M2170 · Commercial52Original policy ↗
Reduced and Discontinued ServicesEffective Mar 1, 2024 · Commercial—Original policy ↗
Reduced and Discontinued ServicesEffective Jan 1, 2026 · Medicaid—Original policy ↗
Reduced and Discontinued ServicesEffective Jan 1, 2024—Original policy ↗
Reduced ServicesEffective Sep 1, 2022 · Commercial—Original policy ↗
Refractive Surgical ProceduresMedicaid6Original policy ↗
Rehabilitative TherapiesCommercial107Original policy ↗
Reimbursement for Items under WarrantyG-06112 · Effective Apr 6, 2023 · Medicaid—Original policy ↗
Reimbursement for Reduced and Discontinued ServicesG-10033 · Effective Nov 18, 2021 · Medicaid—Original policy ↗
Reimbursement Policies Overview (PDF)NCBCBS-CR-RP-059509-24 · Medicaid—Original policy ↗
Reimbursement Policy DisclaimerNCBCBS-CR-RP-059508-24 · Medicaid—Original policy ↗
Remote Electrical Neuromodulation for MigrainesCommercial1Original 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.