Horizon Blue Cross and Blue Shield of New Jersey policies, page 16

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
Surgical Treatment of Snoring and Obstructive Sleep Apnea SyndromeEffective May 11, 2020 · Commercial, Medicaid4Original policy ↗
Surgical Treatments for Breast Cancer-Related LymphedemaCommercial—Original policy ↗
Surgical Ventricular RestorationCommercial—Original policy ↗
Synthetic Cartilage Implants for Joint PainCommercial, Medicaid—Original policy ↗
Systems Pathology in Prostate CancerCommercial, Medicaid—Original policy ↗
T-Wave AlternansCommercial, Medicaid1Original policy ↗
Tagraxofusp-erzs (Elzonris)Commercial—Original policy ↗
Telemedicine and Telehealth ServicesEffective Jun 1, 2016 · Commercial, Medicaid304Original policy ↗
Telemedicine Services Reimbursement Policy: Temporary Addendum for Horizon BCBSNJ Commercial/ASO plans and productsEffective Mar 1, 2020 · Commercial—Original policy ↗
Telemedicine Services Reimbursement Policy: Temporary Addendum for Horizon Medicare AdvantageEffective Mar 1, 2020—Original policy ↗
Temporomandibular Joint DisorderCommercial—Original policy ↗
Teprotumumab-trbw (Tepezza)Commercial—Original policy ↗
Testing Serum Vitamin D LevelsCommercial, Medicaid—Original policy ↗
Testosterone [Implantable Testosterone Pellets (Testopel Pellets), Testosterone Undecanoate (Aveed)], Testosterone Cypionate (Depo-Testosterone), or Testosterone Enanthate (Delatestryl)]Commercial—Original policy ↗
Thermal Capsulorrhaphy as a Treatment of Joint InstabilityCommercial, Medicaid—Original policy ↗
ThermographyEffective Jun 26, 2019 · Commercial—Original policy ↗
Thoracic-Lumbo-Sacral Orthosis with PneumaticsCommercial, Medicaid2Original policy ↗
Threshold Electrical Stimulation as a Treatment of Motor DisordersCommercial, Medicaid—Original policy ↗
Tildrakizumab (Ilumya)Commercial—Original policy ↗
Tisagenlecleucel (Kymriah)Commercial3Original policy ↗
Tocilizumab (Actemra)Commercial—Original policy ↗
Topotecan Hydrochloride (Hycamtin) InjectionCommercial—Original policy ↗
Total Ankle Replacement (Arthroplasty)Effective Dec 3, 2018 · Commercial, Medicaid—Original policy ↗
Total Artificial Hearts and Implantable Ventricular Assist DevicesCommercial, Medicaid2Original policy ↗
Transanal Endoscopic Microsurgery (TEMS)Commercial—Original policy ↗
Transanal Radiofrequency Treatment of Fecal IncontinenceEffective Sep 23, 2019 · Commercial, Medicaid—Original policy ↗
Transcatheter Aortic Valve Implantation for Aortic StenosisCommercial, Medicaid—Original policy ↗
Transcatheter Arterial Chemoembolization To Treat Primary or Metastatic Liver MalignanciesCommercial, Medicaid—Original policy ↗
Transcatheter Mitral Valve RepairCommercial—Original policy ↗
Transcatheter Pulmonary Valve ImplantationEffective Apr 1, 2020 · Commercial—Original policy ↗
Transcranial Magnetic Stimulation as a Treatment of Disorders Other Than Psychiatric/Behavioral Health-Related ConditionsCommercial, Medicaid—Original policy ↗
Transesophageal Endoscopic Therapies for Gastroesophageal Reflux DiseaseCommercial, Medicaid3Original policy ↗
Transmyocardial RevascularizationCommercial—Original policy ↗
Transplant Donor and Recipient PolicyCommercial, Medicaid—Original policy ↗
Transpupillary Thermotherapy for Treatment of Choroidal NeovascularizationCommercial, Medicaid—Original policy ↗
Transurethral Water Vapor Thermal Therapy for Benign Prostatic HyperplasiaCommercial1Original policy ↗
Transvaginal and Transurethral Radiofrequency Tissue Remodeling for Urinary Stress IncontinenceCommercial, Medicaid—Original policy ↗
Trastuzumab (Herceptin), Trastuzumab-dkst (Ogivri), Ado-trastuzumab emtansine (Kadcyla), Trastuzumab-pkrb (Herzuma), Trastuzumab-dttb (Ontruzant), Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta), Trastuzumab-qyyp (Trazimera), Trastuzumab-anns (Kanjinti), Fam-trastuzumab deruxtecan-nxki (Enhertu), Pertuzumab (Perjeta), and Pertuzumab, Trastuzumab, and hyaluronidase-zzxf (Phesgo)Commercial—Original policy ↗
Treatment of TinnitusEffective Jan 11, 2019 · Commercial, Medicaid—Original policy ↗
Treatment of Varicose Veins/Venous InsufficiencyCommercial, Medicaid—Original policy ↗
Triamcinolone Acetonide Extended-Release (Zilretta)Commercial—Original policy ↗
Trigger Point InjectionsCMM-202 · Commercial, Medicaid2Original policy ↗
Tumor Markers Other Than Prostate Specific Antigen (PSA)Commercial, Medicaid8Original policy ↗
Tumor Treating Fields TherapyCommercial, Medicaid1Original policy ↗
TX1 Device for Percutaneous Ultrasonic Tenotomy or Fasciotomy for the Treatment of Chronic PainCommercial, Medicaid—Original policy ↗
UCB-Type Berkeley Shell Custom-Made Foot OrthoticCommercial, Medicaid1Original policy ↗
Ulcer Debridement and Ulcer StagesEffective Feb 25, 2019 · Commercial, Medicaid3Original policy ↗
Ultrafiltration in Decompensated Heart FailureCommercial—Original policy ↗
Ultrasonic Guidance for Knee Joint Injection or AspirationCommercial, Medicaid—Original policy ↗
Ultrasonographic Evaluation of Skin LesionsCommercial, Medicaid—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.

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