Horizon Blue Cross and Blue Shield of New Jersey policies, page 10

Search Horizon Blue Cross and Blue Shield of New Jersey'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.

834 public policies Substrate tracks for Horizon Blue Cross and Blue Shield of New Jersey, by title.

Horizon Blue Cross and Blue Shield of New Jersey policies
PolicyDetailsCodesSource
Leadless Cardiac PacemakerCommercial—Original policy ↗
Lemtrada (Alemtuzumab)Commercial—Original policy ↗
Levoleucovorin (Fusilev and Khapzory)Commercial—Original policy ↗
Liposomal Formulation of Daunorubicin and Cytarabine (Vyxeos)Commercial—Original policy ↗
Liver Transplant and Combined Liver-Kidney TransplantCommercial, Medicaid—Original policy ↗
Low Intensity Pulsed Ultrasound Fracture Healing DeviceCommercial, Medicaid1Original policy ↗
Low-Level Laser TherapyCommercial, Medicaid1Original policy ↗
Lumbar Spinal FusionCommercial—Original policy ↗
Lung and Lobar Lung TransplantCommercial, Medicaid—Original policy ↗
Lung Volume Reduction Surgery for Severe EmphysemaEffective May 28, 2020 · Commercial—Original policy ↗
Lurbinectedin (Zepzelca)Commercial—Original policy ↗
Luspatercept-aamt (Reblozyl)Commercial—Original policy ↗
Lysis of Epidural AdhesionsCommercial, Medicaid—Original policy ↗
Magnetic Esophageal Sphincter Augmentation to Treat Gastroesophageal Reflux DiseaseEffective Oct 8, 2019 · Commercial—Original policy ↗
Magnetic Resonance Imaging-Guided Focused UltrasoundEffective Jul 12, 2020 · Commercial, Medicaid3Original policy ↗
Manipulation Under AnesthesiaCommercial, Medicaid1Original policy ↗
Marqibo (Vincristine Sulfate Liposome Injection)Commercial—Original policy ↗
Mastectomy for GynecomastiaCommercial, Medicaid—Original policy ↗
Maternity ReimbursementEffective Apr 1, 2012 · Commercial, Medicaid15Original policy ↗
Maximum Units for AnesthesiaEffective Dec 14, 2020 · Commercial, Medicaid2Original policy ↗
Measurement of Lipoprotein-Associated Phospholipase A2 in the Assessment of Cardiovascular RiskCommercial1Original policy ↗
Measurement of Long-Chain Omega-3 Fatty Acids in Red Blood Cell Membranes as a Cardiac Risk FactorCommercial, Medicaid—Original policy ↗
Measurement of Serum Antibodies to Infliximab, Adalimumab, Ustekinumab and VedolizumabCommercial—Original policy ↗
Mechanical Stretching Devices for Limited Jaw MobilityCommercial, Medicaid—Original policy ↗
Medical BedsCommercial, Medicaid25Original policy ↗
Medical Nutrition Therapy (MNT)Effective Apr 15, 2021 · Commercial, Medicaid5Original policy ↗
Medical Nutritional Therapy for Inherited Metabolic DiseaseCommercial, Medicaid3Original policy ↗
Medical Policy Development Policy and ProceduresCommercial—Original policy ↗
Medicare Advantage Hospital Sequestration ReimbursementEffective Apr 1, 2022—Original policy ↗
Melanoma VaccinesCommercial, Medicaid—Original policy ↗
Melphalan (Alkeran and Evomela)Commercial—Original policy ↗
Meniscal Allografts and Other Meniscal ImplantsCommercial, Medicaid1Original policy ↗
Microarray-Based Gene Expression Profile Testing for Multiple Myeloma Risk StratificationCommercial1Original policy ↗
Microprocessor-Controlled Prostheses for the Lower LimbCommercial, Medicaid17Original policy ↗
Microwave Thermotherapy for Primary Breast CancerCommercial, Medicaid—Original policy ↗
Microwave Tumor AblationCommercial—Original policy ↗
Miscellaneous Genetic and Molecular Diagnostic TestsCommercial, Medicaid—Original policy ↗
Mitomycin for Pyelocalyceal Solution (Jelmyto)Commercial—Original policy ↗
Mobility DevicesCommercial, Medicaid124Original policy ↗
Moderate Penetrance Variants Associated with Breast Cancer in Individuals at High Breast Cancer RiskCommercial, Medicaid1Original policy ↗
Modifier 25Effective Aug 1, 2006 · Commercial, Medicaid—Original policy ↗
Modifier 52Effective May 15, 2017 · Commercial, Medicaid—Original policy ↗
Modifier 53Effective May 15, 2017 · Commercial, Medicaid—Original policy ↗
Modifier 54Effective May 15, 2017 · Commercial, Medicaid—Original policy ↗
Modifier 55Effective May 15, 2017 · Commercial, Medicaid—Original policy ↗
Modifier 56Effective May 15, 2017 · Commercial, Medicaid—Original policy ↗
Modifier 57Effective Feb 25, 2019 · Commercial, Medicaid4Original policy ↗
Modifier 76Effective Feb 25, 2019 · Commercial—Original policy ↗
Modifier 77Effective Feb 25, 2019 · Commercial—Original policy ↗
Modifier 78Effective May 22, 2025 · Commercial, Medicaid—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.