Horizon Blue Cross and Blue Shield of New Jersey policies, page 13

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
Percutaneous Neurolysis for Trigeminal NeuralgiaCMM-403 · Commercial, Medicaid2Original policy ↗
Percutaneous Tibial Nerve StimulationCommercial, Medicaid—Original policy ↗
Percutaneous Vertebroplasty and SacroplastyEffective Feb 11, 2020 · Commercial, Medicaid8Original policy ↗
Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux (VUR)Commercial, Medicaid—Original policy ↗
Peroral Endoscopic Myotomy for Treatment of Esophageal AchalasiaEffective Sep 9, 2019 · Commercial—Original policy ↗
Pharmacogenetic Testing for Pain ManagementCommercial—Original policy ↗
Photocoagulation of Macular DrusenCommercial, Medicaid—Original policy ↗
Photodynamic Therapy for Choroidal NeovascularizationCommercial, Medicaid—Original policy ↗
Phototherapy for PsoriasisCommercial, Medicaid—Original policy ↗
Phrenic Nerve Stimulation for Central Sleep ApneaCommercial—Original policy ↗
Physical Therapy in the Home and Outpatient SettingCommercial, Medicaid7Original policy ↗
Physician Extenders Non-Surgical ServicesEffective Jul 1, 2016 · Commercial, Medicaid—Original policy ↗
Physician Standby ServiceCommercial, Medicaid1Original policy ↗
Placement of Iliac Vein StentEffective Jul 15, 2019 · Commercial, Medicaid—Original policy ↗
Placental and Umbilical Cord Blood as a Source of Stem CellsCommercial, Medicaid—Original policy ↗
Plasma ExchangeCommercial, Medicaid—Original policy ↗
Plugs for Anal Fistula RepairCommercial—Original policy ↗
Pneumatic Compression Pumps for Treatment of Lymphedema and Venous UlcersCommercial, Medicaid4Original policy ↗
Polatuzumab vedotin-piiq (Polivy)Commercial—Original policy ↗
Polysomnography for Non‒Respiratory Sleep DisordersCommercial—Original policy ↗
Pompe Disease Treatment with Lumizyme (Alglucosidase alfa)Commercial—Original policy ↗
Post-Mastectomy Reconstructive Breast SurgeryCommercial, Medicaid—Original policy ↗
Post-Payment Documentation Requests for Facility ClaimsEffective Feb 15, 2021 · Commercial, Medicaid—Original policy ↗
Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism ProphylaxisCommercial, Medicaid1Original policy ↗
Powered Exoskeleton for Ambulation in Patients with Lower Limb DisabilitiesCommercial, Medicaid1Original policy ↗
Pralatrexate (Folotyn)Commercial—Original policy ↗
Pre-Payment Coding Reviews Documentation RequestsEffective Feb 2, 2023 · Commercial—Original policy ↗
Pre-Payment Documentation Requests: Facility ClaimsEffective Feb 15, 2021 · Commercial, Medicaid—Original policy ↗
Preimplantation Genetic TestingCommercial, Medicaid—Original policy ↗
Prescription Digital Therapeutics for Substance AbuseCommercial, Medicaid—Original policy ↗
Principles of Pain ManagementIntroduction 010 · Commercial, Medicaid—Original policy ↗
Probuphine (Buprenorphine) Implant for Subdermal Administration and Sublocade (Buprenorphine Extended-Release) Injection for Subcutaneous UseCommercial, Medicaid—Original policy ↗
Progenitor Cell Therapy for the Treatment of Damaged Myocardium Due to IschemiaCommercial—Original policy ↗
Progesterone Therapy as a Technique to Reduce Preterm Delivery in High Risk PregnanciesCommercial—Original policy ↗
ProlotherapyEffective Sep 6, 2019 · Commercial, Medicaid—Original policy ↗
Prostatic Urethral LiftCommercial, Medicaid—Original policy ↗
Proteogenomic Testing for Patients With CancerCommercial—Original policy ↗
Proteomic Testing for Targeted Therapy in Non-Small Cell Lung CancerEffective Aug 28, 2019 · Commercial1Original policy ↗
Proton Beam TherapyCommercial, Medicaid—Original policy ↗
Public Health EmergencyCommercial—Original policy ↗
Pulmonary Diagnostic Procedures when billed with E&M CodesEffective Feb 25, 2019 · Commercial14Original policy ↗
Quantitative Assay for Measurement of HER2 Total Protein Expression and HER2 DimersCommercial—Original policy ↗
Quantitative Electroencephalography as a Diagnostic Aid for Attention-Deficit/Hyperactivity DisorderCommercial—Original policy ↗
Quantitative Sensory TestingEffective Apr 3, 2019 · Commercial—Original policy ↗
Radiation Therapy - Xofigo®Commercial, Medicaid—Original policy ↗
Radiation Therapy for Anal Canal CancerCommercial—Original policy ↗
Radiation Therapy for Bladder CancerCommercial—Original policy ↗
Radiation Therapy for Bone MetastasesCommercial2Original policy ↗
Radiation Therapy for Brain MetastasesCommercial3Original policy ↗
Radiation Therapy for Breast CancerCommercial, Medicaid2Original 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.