Horizon Blue Cross and Blue Shield of New Jersey policies, page 11

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
Modifier 90Effective Nov 15, 2025 · Commercial—Original policy ↗
Modifier SUEffective Jul 26, 2014 · Commercial, Medicaid—Original policy ↗
Modifiers 59, XE, XP, XS and XUEffective Jan 1, 2009 · Commercial, Medicaid41Original policy ↗
Modifiers CQ/COEffective Jun 20, 2022 · Commercial, Medicaid—Original policy ↗
Mogamulizumab-kpkc (Poteligeo)Commercial—Original policy ↗
Molecular Analysis for Targeted Therapy for Non-Small-Cell Lung CancerCommercial—Original policy ↗
Molecular Gastrointestinal Pathogen Panel (GIPP) TestingEffective Dec 30, 2019 · Commercial4Original policy ↗
Molecular Markers in Fine Needle Aspirates of the ThyroidCommercial, Medicaid—Original policy ↗
Molecular Testing for Chronic Heart Failure and Heart TransplantCommercial, Medicaid—Original policy ↗
Molecular Testing for the Management of Pancreatic Cysts, Barrett Esophagus, and Solid Pancreatic LesionsCommercial, Medicaid—Original policy ↗
Molecular Testing in the Management of Pulmonary NodulesEffective Mar 9, 2020 · Commercial—Original policy ↗
Monoclonal Interleukin-5 Antagonists [mepolizumab (Nucala), reslizumab (Cinqair), and benralizumab (Fasenra)]Commercial—Original policy ↗
Moxetumomab Pasudotox-tdfk (Lumoxiti)Commercial—Original policy ↗
Mozobil® (Plerixafor Injection)Commercial—Original policy ↗
Multibiomarker Disease Activity Blood Test for Rheumatoid ArthritisCommercial, Medicaid1Original policy ↗
Multimarker Serum Testing Related to Ovarian CancerCommercial1Original policy ↗
Multiple Procedure Reductions (Modifier -51)Effective Jan 1, 2009 · Commercial, Medicaid—Original policy ↗
Multitarget Polymerase Chain Reaction Testing for Diagnosis of Bacterial VaginosisCommercial—Original policy ↗
Myoelectric Prosthetic and Orthotic Components for the Upper LimbCommercial, Medicaid12Original policy ↗
Natalizumab (Tysabri)Commercial—Original policy ↗
National Coverage Determinations/Local Coverage DeterminationsMedicaid—Original policy ↗
Navigated Transcranial Magnetic StimulationCommercial, Medicaid—Original policy ↗
Negative-Pressure Wound TherapyCommercial, Medicaid4Original policy ↗
Nerve Fiber Density MeasurementCommercial, Medicaid—Original policy ↗
Nerve Graft with Radical ProstatectomyCommercial—Original policy ↗
Neural TherapyCommercial, Medicaid—Original policy ↗
NeurofeedbackCommercial, Medicaid—Original policy ↗
Neuromuscular Electrical Stimulation (NMES) and Functional Electrical Stimulation (FES)Commercial, Medicaid—Original policy ↗
Neutron Beam TherapyCommercial—Original policy ↗
Never EventsEffective Dec 30, 2024 · Commercial, Medicaid—Original policy ↗
Next-Generation Sequencing for the Assessment of Measurable Residual DiseaseCommercial—Original policy ↗
Nivolumab (Opdivo)Commercial—Original policy ↗
Non Oral Drug Therapy for Pulmonary Hypertension7Original policy ↗
Non-Contact Ultrasound Treatment for WoundsEffective Nov 1, 2018 · Commercial, Medicaid—Original policy ↗
Non-ESRD ESA Level ReportingEffective Mar 18, 2019 · Commercial4Original policy ↗
Non-Pharmacologic Treatment of RosaceaCommercial6Original policy ↗
Noncovered Related ServicesEffective Mar 23, 2015 · Commercial, Medicaid—Original policy ↗
Noninvasive Electroencephalography (EEG)Commercial, Medicaid—Original policy ↗
Noninvasive Fetal RHD Genotyping Using Cell-Free Fetal DNACommercial, Medicaid—Original policy ↗
Noninvasive Prenatal Screening for Fetal Aneuploidies, Microdeletions, and Twin Zygosity Using Cell-Free Fetal DNACommercial, Medicaid1Original policy ↗
Noninvasive Techniques for the Evaluation and Monitoring of Patients with Chronic Liver DiseaseCommercial—Original policy ↗
Novel Biomarkers in Risk Assessment and Management of Cardiovascular DiseaseCommercial1Original policy ↗
Nusinersen (Spinraza)Commercial—Original policy ↗
Nutrient/Nutritional Panel TestingCommercial3Original policy ↗
Nutritional Support (Infant Formulas, Enteral Nutrition and Total Parenteral Nutrition)Commercial, Medicaid10Original policy ↗
Observation CareCommercial, Medicaid—Original policy ↗
Obstetrical Ultrasound PolicyCommercial, Medicaid28Original policy ↗
Occipital Nerve StimulationCommercial—Original policy ↗
Occupational Therapy in the Home and Outpatient SettingCommercial, Medicaid5Original policy ↗
Ocrelizumab (Ocrevus)Commercial—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.