Blue Cross NC policies, page 20

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
Transcranial Magnetic Stimulation as a Treatment of Depression and Other Psychiatric/Neurologic Disorders NotificationCommercial10Original policy ↗
Transcranial Magnetic Stimulation as a Treatment of Depression and Other Psychiatric/Neurologic Disorders NotificationCommercial10Original policy ↗
Transplant Rejection Testing AHS - M2091M2091 · Commercial21Original policy ↗
Transplant Rejection Testing AHS - M2091 NotificationM2091 · Commercial24Original policy ↗
Transportation and Lodging Related to TransplantsMedicaid—Original policy ↗
Transportation Services: Ambulance and Non-Emergent TransportG-07036 · Effective May 22, 2024 · Medicaid—Original policy ↗
Transurethral Water Vapor Thermal Therapy and Transurethral Water Jet Ablation (Aquablation) for Benign Prostatic HyperplasiaCommercial3Original policy ↗
Transurethral Water Vapor Thermal Therapy and Transurethral Water Jet Ablation (Aquablation) for Benign Prostatic HyperplasiaCommercial4Original policy ↗
Transurethral Water Vapor Thermal Therapy for Benign Prostatic HyperplasiaCommercial1Original policy ↗
Transurethral Water Vapor Thermal Therapy for Benign Prostatic HyperplasiaCommercial95Original policy ↗
Transurethral Water Vapor Thermal Therapy for Benign Prostatic HyperplasiaCommercial1Original policy ↗
Treatment For Opioid Use Disorder in Opioid Treatment Programs (OTPs)Commercial19Original policy ↗
Trelstar Prior Authorization Criteria - Medicare Part D—Original policy ↗
Trientine Prior Authorization (with Quantity Limit) Criteria - Medicare Part D—Original policy ↗
Trigger Point and Tender Point InjectionsCommercial2Original policy ↗
Trigger Point and Tender Point InjectionsCommercial2Original policy ↗
Trikafta Prior Authorization Criteria - Medicare Part D—Original policy ↗
Tumor Treatment Fields TherapyCommercial5Original policy ↗
Tymlos Prior Authorization Criteria - Medicare Part D—Original policy ↗
Type I Diabetes Reference Guide (PDF)Commercial—Original policy ↗
Type II Diabetes Reference GuideEffective Feb 28, 2025 · Commercial—Original policy ↗
Ubrelvy Prior Authorization with Quantity Limit Criteria - Medicare Part D—Original policy ↗
Ultrasound Accelerated Fracture Healing DeviceCommercial2Original policy ↗
Understanding Your Role in the Health Outcomes SurveyNCBCBS-CR-055930-24-CPN55629 · Medicaid—Original policy ↗
Unlisted or Miscellaneous CodesG-06004 · Effective Nov 4, 2024 · Medicaid—Original policy ↗
Unplanned Return to SurgeryCommercial—Original policy ↗
Unplanned Return to Surgery—Original policy ↗
Upper Limb ProstheticsMedicaid16Original policy ↗
Urea Cycle Disorders - Sodium phenylbutyrate Prior Authorization Criteria - Medicare Part D—Original policy ↗
Urinary Tumor Markers for Bladder Cancer AHS - G2125G2125 · Commercial21Original policy ↗
Urine Culture Testing for Bacteria AHS - G2156G2156 · Commercial16Original policy ↗
Urine Culture Testing for Bacteria AHS – G2156G2156 · Commercial15Original policy ↗
Use of Common Genetic Variants to Predict Risk of Non-Familial Breast Cancer AHS - M2126M2126 · Commercial3Original policy ↗
Use of Common Genetic Variants to Predict Risk of Non-Familial Breast Cancer AHS-M2126AHS-M2126 · Commercial1Original policy ↗
Vagus Nerve StimulationCommercial43Original policy ↗
Valchlor Prior Authorization (with Quantity Limit) Criteria - Medicare Part D—Original policy ↗
Value Prior Authorization Criteria (PDF)Commercial—Original policy ↗
Varicose Veins of the Lower Extremities, Treatment forCommercial38Original policy ↗
Vectra DA Blood Test for Rheumatoid Arthritis AHS – G2127G2127 · Commercial2Original policy ↗
Venous and Arterial Thrombosis Risk Testing AHS - M2041M2041 · Commercial14Original policy ↗
Venous Thrombosis Risk Testing AHS – M2041M2041 · Commercial13Original policy ↗
Veozah Prior Authorization Criteria - Medicare Part D—Original policy ↗
Vesicoureteral Reflux, Treatment with Periureteral Bulking AgentsCommercial4Original policy ↗
Vestibular Function TestingCommercial13Original policy ↗
Viberzi Prior Authorization with Quantity Limit Criteria - Medicare Part D—Original policy ↗
Viekira Pak Prior Authorization Criteria - Medicare Part D—Original policy ↗
Viscocanalostomy and CanaloplastyCommercial2Original policy ↗
Vitamin B12 and Methylmalonic Acid Testing AHS - G2014G2014 · Commercial4Original policy ↗
Vitamin B12 and Methylmalonic Acid Testing AHS – G2014G2014 · Commercial3Original policy ↗
Vitamin B12 and Methylmalonic Acid Testing AHS – G2014 NotificationG2014 · Commercial4Original 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.