Blue Cross NC policies, page 19

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
Synthetic Cartilage Implants for Joint PainCommercial5Original policy ↗
Tadalafil Prior Authorization Criteria - Medicare Part D—Original policy ↗
Tasimelteon Prior Authorization (with Quantity Limit) Criteria - Medicare Part D—Original policy ↗
Technology Assisted Surgical ProceduresG-10004 · Effective Sep 1, 2023 · Medicaid1Original policy ↗
TelehealthCommercial176Original policy ↗
Telehealth3Original policy ↗
Telehealth Medicare Reimbursement PolicyEffective Sep 1, 20263Original policy ↗
Temporomandibular Joint Dysfunction (TMJD)Commercial19Original policy ↗
Temporomandibular Joint Dysfunction SurgeryEffective Jun 15, 2026 · Medicaid15Original policy ↗
TENS (Transcutaneous Electrical Nerve Stimulator)Commercial30Original policy ↗
Teriparatide Prior Authorization Criteria - Medicare Part D—Original policy ↗
Testing for 5-Fluorouracil Use in Cancer Patients AHS - M2067M2067 · Commercial6Original policy ↗
Testing for Alpha-1 Antitrypsin Deficiency AHS - M2068M2068 · Commercial6Original policy ↗
Testing for Alpha-1 Antitrypsin Deficiency AHS - M2068M2068 · Commercial6Original policy ↗
Testing for Autism Spectrum Disorder and Developmental Delay AHS – M2176M2176 · Commercial5Original policy ↗
Testing for Colorectal Cancer Management AHS - M2026M2026 · Commercial13Original policy ↗
Testing for Developmental Delay AHS - M2176M2176 · Commercial7Original policy ↗
Testing for Developmental Delay AHS – M2176 NotificationM2176 · Commercial7Original policy ↗
Testing for Diagnosis of Active or Latent Tuberculosis AHS - G2063G2063 · Commercial55Original policy ↗
Testing for Mosquito or Tick-Related Infections AHS – G2158G2158 · Commercial19Original policy ↗
Testing for Targeted Therapy of Non-Small-Cell Lung Cancer AHS - M2030M2030 · Commercial28Original policy ↗
Testing for Targeted Therapy of Non-Small-Cell Lung Cancer AHS - M2030 "Notification"M2030 · Commercial27Original policy ↗
Testing for Targeted Therapy of Non-Small-Cell Lung Cancer AHS-M2030AHS-M2030 · Commercial17Original policy ↗
Testing for Vector-Borne Infections AHS – G2158G2158 · Commercial25Original policy ↗
Testing for Vector-Borne Infections AHS – G2158G2158 · Commercial28Original policy ↗
Testing for Vector-Borne Infections AHS – G2158G2158 · Commercial25Original policy ↗
Testing of Homocysteine Metabolism Related Conditions AHS - M2141M2141 · Commercial13Original policy ↗
Testing of Homocysteine Metabolism Related Conditions AHS - M2141 NotificationM2141 · Commercial13Original policy ↗
Testosterone AHS – G2013G2013 · Commercial15Original policy ↗
Testosterone Testing AHS – G2013G2013 · Commercial3Original policy ↗
Tetrabenazine Prior Authorization (with Quantity Limit) Criteria - Medicare Part D—Original policy ↗
The Blue Book Provider e-ManualCommercial, Medicaid503Original policy ↗
Three Dimensional Printed Orthopedic ImplantsCommercial1Original policy ↗
Thyroid Disease Testing AHS – G2045G2045 · Commercial17Original policy ↗
Thyroid Disease Testing AHS – G2045 NotificationG2045 · Commercial17Original policy ↗
Tier Exception Criteria - Medicare Part D—Original policy ↗
Time to Prepare for HEDIS Medical Record Review (PDF)NCBCBS-CR-071175-24-CPN71157 · Medicaid—Original policy ↗
Tinnitus TreatmentCommercial11Original policy ↗
Tocilizumab (Actemra)Commercial2Original policy ↗
Tolvaptan (generic Samsca) Prior Authorization Criteria – Medicare Part D—Original policy ↗
Top Performing Provider Quality Designation Methodology GuideCommercial—Original policy ↗
Topical Diclofenac – Diclofenac 3% Gel Prior Authorization Criteria - Medicare Part D—Original policy ↗
Topical Negative Pressure Therapy for WoundsCommercial20Original policy ↗
Topical Negative Pressure Therapy for Wounds "Notification"Commercial20Original policy ↗
Topical Retinoids – Tazarotene and tretinoin Prior Authorization Criteria – Medicare Part D—Original policy ↗
Total Facet ArthroplastyCommercial1Original policy ↗
Transanal Endoscopic Microsurgery (TEMS)Commercial1Original policy ↗
Transcatheter Closure of Ventricular Septal DefectsCommercial5Original policy ↗
Transcatheter Heart Valve ProceduresCommercial33Original policy ↗
Transcranial Magnetic Stimulation as a Treatment of Depression and Other Psychiatric/Neurologic DisordersCommercial10Original 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.