Blue Cross NC policies, page 17

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
Remote Electrical Neuromodulation for Migraines “Notification”Commercial1Original policy ↗
Remote Therapeutic and Physiologic MonitoringCommercial15Original policy ↗
Removal of Impacted CerumenCommercial5Original policy ↗
Renal (Kidney) TransplantationCommercial14Original policy ↗
Renal Denervation as a Treatment of HypertensionCommercial6Original policy ↗
Renal Denervation as a Treatment of Hypertension "Notification"Commercial6Original policy ↗
Repatha Prior Authorization (with Quantity Limit) Criteria - Medicare Part DEffective Jan 1, 2025—Original policy ↗
Request for Authorization: Neuropsychological TestingBNCCARE-0204-21 · Medicaid3Original policy ↗
Request for Waiver of Brand Drug Additional FeesCommercial—Original policy ↗
Residential TreatmentCommercial4Original policy ↗
Residential TreatmentCommercial4Original policy ↗
Resources to Support Diverse Patients and CommunitiesNCBCBS-CR-076855-24-CPN75666 · Medicaid—Original policy ↗
Retinal ProsthesisCommercial7Original policy ↗
Revenue Codes Requiring Procedure Codes, FacilityCommercial—Original policy ↗
Revenue Codes Requiring Procedure Codes, FacilityMedicaid—Original policy ↗
RhinoplastyCommercial10Original policy ↗
RhinoplastyCommercial10Original policy ↗
Rho Kinase Inhibitors Prior Authorization Criteria – Medicare Part D—Original policy ↗
Sacral Nerve Neuromodulation/Stimulation for Pelvic Floor DysfunctionCommercial39Original policy ↗
Salivary Hormone Testing AHS - G2120G2120 · Commercial16Original policy ↗
Salivary Hormone Testing AHS – G2120G2120 · Commercial14Original policy ↗
Sanctioned and Opt-Out Providers (PDF)G-10002 · Medicaid—Original policy ↗
Sapropterin Prior Authorization Criteria - Medicare Part D—Original policy ↗
Screening for Vertebral Fracture with Dual X-ray Absorptiometry (DXA)Commercial4Original policy ↗
Semi-Implantable and Fully Implantable Middle Ear Hearing AidCommercial8Original policy ↗
SeptoplastyCommercial1Original policy ↗
Serum Testing for Evidence of Mild Traumatic Brain Injury AHS - G2151G2151 · Commercial4Original policy ↗
Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease AHS - G2110G2110 · Commercial12Original policy ↗
Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease AHS - G2110G2110 · Commercial12Original policy ↗
Serum Tumor Markers for Malignancies AHS - G2124G2124 · Commercial78Original policy ↗
Services Bundled into Inpatient / Outpatient StaysCommercial2Original policy ↗
Services Bundled into Inpatient / Outpatient StaysCommercial2Original policy ↗
Services Bundled into Inpatient / Outpatient Stays NotificationCommercial2Original policy ↗
Sex Trait Modification Procedures For Gender Affirming CareCommercial94Original policy ↗
Shortage of Repackaged Bevacizumab for Ophthalmic Use (PDF)PCTS-1044 · Medicaid—Original policy ↗
Signal-Averaged ECGCommercial1Original policy ↗
Signifor LAR Prior Authorization Criteria – Medicare Part D—Original policy ↗
Sivextro tablets Prior Authorization Criteria – Medicare Part D—Original policy ↗
Skilled Nursing Facility CareCommercial—Original policy ↗
Skilled Nursing Facility — Vaccine Serum Compensation (PDF)NCBCBS-CR-070571-24-CPN70382 · Medicaid—Original policy ↗
Skilled Nursing ServicesMED1391 · Commercial38Original policy ↗
Skin and Soft Tissue SubstitutesCommercial406Original policy ↗
Sleep Apnea: Diagnosis and Medical ManagementCommercial83Original policy ↗
Small Bowel, Small Bowel with Liver, or Multivisceral TransplantCommercial27Original policy ↗
Sodium Oxybate - Xywav Prior Authorization (with Quantity Limit) Criteria - Medicare Part D—Original policy ↗
Sodium Oxybate Prior Authorization (with Quantity Limit) Criteria - Medicare Part D—Original policy ↗
Somatostatin Analogs - Octreotide Prior Authorization Criteria - Medicare Part D—Original policy ↗
Somatostatin Analogs - Somatuline Depot Prior Authorization Criteria - Medicare Part D—Original policy ↗
Somatostatin Analogs - Somavert Prior Authorization Criteria – Medicare Part D—Original policy ↗
Sovaldi Prior Authorization Criteria - Medicare Part D—Original policy ↗

Back to Blue Cross NC · Blue Cross NC prior authorization CPT list

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.