Horizon Blue Cross and Blue Shield of New Jersey policies, page 12

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
Ocriplasmin (Jetrea®)Commercial—Original policy ↗
Ofatumumab (Arzerra)Commercial—Original policy ↗
Off-Label Use of Prescription DrugsCommercial—Original policy ↗
Olaratumab (Lartruvo)Commercial—Original policy ↗
Omacetaxine Mepesuccinate (Synribo)Commercial—Original policy ↗
Omalizumab (Xolair)Commercial—Original policy ↗
Onasemnogene Abeparvovec (Zolgensma)Commercial—Original policy ↗
Onivyde (Irinotecan Liposome Injection)Commercial—Original policy ↗
Open and Thoracoscopic Approaches to Treat Atrial Fibrillation and Atrial Flutter (Maze and Related Procedures)Commercial, Medicaid—Original policy ↗
Ophthalmologic Techniques that Evaluate the Posterior Segment for GlaucomaCommercial, Medicaid—Original policy ↗
Opioid Antagonists Under Heavy Sedation or General Anesthesia as a Technique of Opioid DetoxificationCommercial, Medicaid—Original policy ↗
Optical Coherence Tomography (OCT) of the Anterior Eye SegmentCommercial, Medicaid—Original policy ↗
Optical Coherence Tomography for Imaging of Coronary ArteriesEffective Sep 30, 2019 · Commercial, Medicaid—Original policy ↗
Orphan DrugsCommercial—Original policy ↗
Orthognathic SurgeryCommercial, Medicaid—Original policy ↗
Orthopedic Applications of Platelet-Rich PlasmaCommercial, Medicaid—Original policy ↗
Orthopedic Applications of Stem Cell Therapy (Including Allografts and Bone Substitutes Used with Autologous Bone Marrow)Commercial, Medicaid—Original policy ↗
Oscillatory Devices for the Treatment of Cystic Fibrosis and Other Respiratory DisordersCommercial, Medicaid—Original policy ↗
Outpatient Facility Claim Coding RequirementsEffective Mar 29, 2024 · Commercial, Medicaid—Original policy ↗
Outpatient Laboratory Claims: Referring Practitioner RequiredEffective Nov 15, 2019 · Commercial, Medicaid—Original policy ↗
Outpatient Pulmonary RehabilitationCommercial, Medicaid1Original policy ↗
Outpatient Services Prior to Admission or Same-Day SurgeryEffective Jan 1, 2023 · Commercial, Medicaid—Original policy ↗
Outpatient Therapy Daily MaximumEffective Oct 2, 2005 · Commercial, Medicaid66Original policy ↗
Ovarian and Internal Iliac Vein Endovascular Occlusion as a Treatment of Pelvic Congestion SyndromeCommercial, Medicaid—Original policy ↗
Oxaliplatin (Eloxatin)Commercial—Original policy ↗
Paclitaxel Protein-Bound Particles (Abraxane)Commercial—Original policy ↗
Paraspinal Surface Electromyography (SEMG) to Evaluate and Monitor Back PainCommercial, Medicaid1Original policy ↗
Partial Left VentriculectomyCommercial, Medicaid—Original policy ↗
Patient-Controlled End Range of Motion Stretching DevicesCommercial, Medicaid—Original policy ↗
Patient-Specific Instrumentation (e.g., Cutting Guides) for Joint ArthroplastyEffective Feb 11, 2020 · Commercial—Original policy ↗
Patisiran (Onpattro)Commercial—Original policy ↗
Pediatric Abdomen Imaging PolicyCommercial, Medicaid63Original policy ↗
Pediatric Cardiac Imaging PolicyCommercial, Medicaid89Original policy ↗
Pediatric Chest Imaging PolicyCommercial, Medicaid30Original policy ↗
Pediatric Head Imaging PolicyCommercial, Medicaid67Original policy ↗
Pediatric Intensive Feeding ProgramsCommercial, Medicaid—Original policy ↗
Pediatric Musculoskeletal Imaging PolicyCommercial, Medicaid61Original policy ↗
Pediatric Neck Imaging PolicyMedicaid45Original policy ↗
Pediatric Oncology Imaging PolicyEffective Nov 23, 2020 · Commercial, Medicaid17Original policy ↗
Pediatric Pelvis Imaging PolicyCommercial, Medicaid40Original policy ↗
Pediatric Peripheral Nerve Disorder Imaging PolicyCommercial, Medicaid45Original policy ↗
Pediatric Peripheral Vascular Disorder Imaging PolicyCommercial, Medicaid31Original policy ↗
Pediatric Spine Imaging PolicyCommercial, Medicaid48Original policy ↗
Pegloticase (Krystexxa®)Commercial—Original policy ↗
Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence and Dynamic Rectal Control System as a Treatment of Fecal IncontinenceCommercial, Medicaid1Original policy ↗
Pembrolizumab (Keytruda)Commercial—Original policy ↗
Pemetrexed Disodium (Alimta®)Commercial—Original policy ↗
Percutaneous Balloon Kyphoplasty, Radiofrequency Kyphoplasty, and Mechanical Vertebral AugmentationCommercial, Medicaid—Original policy ↗
Percutaneous Intradiscal Electrothermal Annuloplasty, Radiofrequency Annuloplasty, and BiacuplastyEffective Feb 11, 2020 · Commercial, Medicaid—Original policy ↗
Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial FibrillationCommercial—Original policy ↗

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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.