Blue Cross NC policies, page 18

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
Specialty Pharmacy Preapproval List Update (PDF)NCBCBS-CR-077556-25-CPN77132 · Medicaid1Original policy ↗
Specialty Pharmacy Precertification and Step Therapy List ExpansionNCBCBS-CR-071022-24-CPN70592 · Effective Apr 1, 2025 · Medicaid5Original policy ↗
Specialty Pharmacy Precertification List ExpandedNCBCBS-CR-084098-25-CPN83702 · Effective Nov 1, 2025 · Medicaid3Original policy ↗
Specialty Pharmacy Precertification List ExpansionNCBCBS-CR-072460-24-CPN72386 · Effective Apr 1, 2025 · Medicaid3Original policy ↗
Specialty Pharmacy Precertification List Expansion — Key Updates (PDF)NCBCBS-CR-082706-25-CPN81629 · Medicaid4Original policy ↗
Specific OTC Drugs That Are Not Covered (PDF)Commercial—Original policy ↗
Speech Generating DevicesCommercial10Original policy ↗
Speech Generating DevicesCommercial9Original policy ↗
Speech Therapy Supplement (PDF)Commercial—Original policy ↗
Spinal Manipulation Under AnesthesiaCommercial2Original policy ↗
Split Surgical PackageCommercial—Original policy ↗
Split Surgical Package—Original policy ↗
Split-Care Surgical ModifiersG-11005 · Effective Jan 1, 2021 · Medicaid—Original policy ↗
ST2 Assay for Chronic Heart Failure AHS – G2130G2130 · Commercial2Original policy ↗
Status CodesCommercial84Original policy ↗
Status Codes—Original policy ↗
Status CodesMedicaid—Original policy ↗
Stem-cell Therapy for Peripheral Arterial DiseaseCommercial3Original policy ↗
SterilizationG-06163 · Effective Jul 17, 2024 · Medicaid—Original policy ↗
Streamline Your Workflow: Submit Behavioral Health (BH) Authorizations Through Availity Essentials (PDF)NCBCBS-CR-091956-25-CPN91174 · Medicaid—Original policy ↗
Streamlining Behavioral Health Authorizations via Availity Essentials (PDF)NCBCBS-CR-084335-25-CPN83621 · Medicaid—Original policy ↗
Strensiq Prior Authorization Criteria – Medicare Part D—Original policy ↗
Submitting BH Authorizations in Availity Essentials (PDF)NCBCBS-CR-084277-25-CPN83622 · Medicaid—Original policy ↗
Substance Use Disorder Documentation and Coding (PDF)Commercial—Original policy ↗
Substance Use Disorder Intensive Outpatient ProgramsCommercial1Original policy ↗
Substance Use Disorder Intensive Outpatient ProgramsCommercial1Original policy ↗
Substance Use Disorder Partial Hospitalization ProgramsCommercial1Original policy ↗
Substance Use Disorder Partial Hospitalization ProgramsCommercial1Original policy ↗
Substrate Reduction Therapy – Miglustat and Yargesa Prior Authorization (with Quantity Limit) Criteria - Medicare Part D—Original policy ↗
Subtalar ArthroereisisCommercial7Original policy ↗
Supplemental GuideU37164 · Medicaid26Original policy ↗
Supply and EquipmentCommercial44Original policy ↗
Supply and EquipmentCommercial43Original policy ↗
Supply and Equipment NotificationCommercial44Original policy ↗
Supply and Equipment ReimbursementEffective Jul 1, 202431Original policy ↗
Supply and Equipment Reimbursement31Original policy ↗
Supply and Equipment Reimbursement MAEffective Jun 1, 202231Original policy ↗
Supply and Equipment Reimbursement NotificationEffective Aug 1, 202631Original policy ↗
Surgery for Groin Pain in AthletesCommercial3Original policy ↗
Surgery for Morbid ObesityCommercial35Original policy ↗
Surgery for Obstructive Sleep Apnea and Upper Airway Resistance SyndromeCommercial99Original policy ↗
Surgical Deactivation of Headache Trigger SitesCommercial10Original policy ↗
Surgical Treatment for LipedemaCommercial10Original policy ↗
Surgical Treatment of Chest Wall Deformities (Congenital or Acquired)Commercial3Original policy ↗
Surgical Treatment of Sinus DiseaseCommercial26Original policy ↗
Surgical Treatments for Breast Cancer-Related Lymphedema NotificationCommercial1Original policy ↗
Surgical Treatments for LymphedemaCommercial4Original policy ↗
Surgical Treatments for Lymphedema NotificationCommercial4Original policy ↗
Surgical Ventricular RestorationCommercial1Original policy ↗
Symdeko Prior Authorization Criteria - Medicare Part D—Original 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.