Blue Cross NC policies
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.
Checking prior authorization for J3490? Open Blue Cross NC’s official lists and confirm the member’s product there.
8 policies name J3490, those listing the fewest codes first. A policy that names a code may also list it as excluded.
| Policy | Details | Codes | Source |
|---|---|---|---|
| Hormone Pellet Implantation for Treatment of Menopause Related Symptoms | Commercial | 3 | Original policy ↗ |
| Specialty Pharmacy Precertification List Expanded | NCBCBS-CR-084098-25-CPN83702 · Effective Nov 1, 2025 · Medicaid | 3 | Original policy ↗ |
| Expanded Specialty Pharmacy Precertification List | NCBCBS-CR-088608-25-CPN87316 · Effective Nov 1, 2025 · Medicaid | 5 | Original policy ↗ |
| Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric Disorders | Commercial | 5 | Original policy ↗ |
| Cemiplimab-rwlc (Libtayo®) | Commercial | 6 | Original policy ↗ |
| NDC Requirements | 8 | Original policy ↗ | |
| Islet Cell Transplantation | Commercial | 16 | Original policy ↗ |
| Surgical Treatment of Sinus Disease | Commercial | 26 | Original policy ↗ |
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