Horizon Blue Cross and Blue Shield of New Jersey policies, page 4

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
Computerized Corneal Topography/VideokeratographyCommercial, Medicaid—Original policy ↗
Cone Beam Computed TomographyCommercial, Medicaid—Original policy ↗
Confocal Laser EndomicroscopyCommercial, Medicaid3Original policy ↗
Conscious SedationEffective Jun 1, 2006 · Commercial, Medicaid7Original policy ↗
Consultation Services PaymentEffective Nov 16, 2015 · Commercial, Medicaid33Original policy ↗
Consumable Medical SuppliesEffective May 1, 2016 · Commercial, Medicaid—Original policy ↗
Continuous or Intermittent Monitoring of Glucose in the Interstitial FluidCommercial, Medicaid5Original policy ↗
Continuous Passive Motion DeviceCommercial, Medicaid1Original policy ↗
Continuous Positive Airway Pressure or Bi-level Positive airway Pressure (CPAP/BiPAP) SuppliesEffective Jan 1, 2012 · Commercial, Medicaid15Original policy ↗
Cooling Devices Used in the Outpatient SettingCommercial—Original policy ↗
Copanlisib (Aliqopa)Commercial—Original policy ↗
Corneal Collagen Cross-LinkingCommercial, Medicaid—Original policy ↗
Coronary Computed Tomography Angiography With Selective Noninvasive Fractional Flow ReserveCommercial—Original policy ↗
Cosmetic ProceduresCommercial, Medicaid—Original policy ↗
Cranial Electrotherapy Stimulation and Auricular ElectrostimulationCommercial, Medicaid—Original policy ↗
Crizanlizumab-tmca (Adakveo)Commercial—Original policy ↗
Cryosurgical Ablation of Miscellaneous Solid Tumors Other Than Liver, Prostate, or Dermatologic TumorsCommercial, Medicaid—Original policy ↗
Cryosurgical Ablation of Primary or Metastatic Liver TumorsCommercial—Original policy ↗
Cupping TherapyCommercial, Medicaid—Original policy ↗
Cutaneous Electrogastrography (EGG)Commercial, Medicaid—Original policy ↗
Cytochrome P450 Genotype-Guided Treatment StrategyCommercial, Medicaid—Original policy ↗
Daily Management of Epidural or Subarachnoid Continuous Drug AdministrationEffective Jun 1, 2006 · Commercial, Medicaid1Original policy ↗
Daily Maximum Units for Surgical Pathology and Microscopic ExaminationEffective Feb 25, 2019 · Commercial, Medicaid1Original policy ↗
Daratumumab (Darzalex), Daratumumab and hyaluronidase-fihj (Darzalex Faspro)Commercial—Original policy ↗
Decompression of the Intervertebral Disc Using Laser Energy (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty)Effective Feb 11, 2020 · Commercial, Medicaid—Original policy ↗
Deep Brain StimulationCommercial—Original policy ↗
Definition of Investigational/Experimental ProcedureCommercial, Medicaid—Original policy ↗
Definition of Medical EmergencyCommercial, Medicaid—Original policy ↗
Definition of Medical NecessityCommercial—Original policy ↗
Denosumab (Prolia, Xgeva)Commercial—Original policy ↗
Dental PoliciesCommercial—Original policy ↗
Dermatologic Applications of Photodynamic TherapyCommercial, Medicaid—Original policy ↗
Description of the Clinical Policy CommitteeCommercial, Medicaid—Original policy ↗
Determination of Refractive StateEffective Nov 16, 20162Original policy ↗
Diabetic Screening ServicesEffective Feb 25, 2019 · Commercial, Medicaid—Original policy ↗
Diabetic SuppliesEffective Jan 1, 2012 · Commercial, Medicaid19Original policy ↗
Diagnosis and Medical Management of Obstructive Sleep Apnea SyndromeCommercial, Medicaid8Original policy ↗
Diagnosis and Treatment of Chronic Cerebrospinal Venous Insufficiency in Multiple SclerosisCommercial, Medicaid—Original policy ↗
DiscectomyCommercial—Original policy ↗
DiscographyCMM-401 · Commercial, Medicaid4Original policy ↗
DME Rent to PurchaseEffective Feb 1, 2011 · Commercial—Original policy ↗
DNA-Based Testing for Adolescent Idiopathic ScoliosisCommercial—Original policy ↗
Donor Lymphocyte Infusion for Malignancies Treated with an Allogeneic Hematopoietic Stem-Cell TransplantCommercial, Medicaid—Original policy ↗
Doula ServicesEffective Jan 1, 2023 · Commercial4Original policy ↗
Drug and Immunization PricingEffective Mar 1, 2007 · Commercial, Medicaid—Original policy ↗
Drug Testing in Pain Management and Substance Use Disorder Treatment SettingsCommercial, Medicaid—Original policy ↗
Drug Therapy for Hereditary Angioedema [Cinryze, Berinert, Haegarda (Human C1 Inhibitor), Kalbitor (Ecallantide), Firazyr (Icatibant), Ruconest (C1 Esterase Inhibitor [Recombinant]), Takhzyro (lanadelumab-flyo)]Commercial—Original policy ↗
Drug Therapy for Transgender PolicyCommercial—Original policy ↗
Drug Wastage – Modifier JWEffective Mar 18, 2019 · Commercial, Medicaid—Original policy ↗
Dry Needling of Myofascial Trigger PointsCommercial, 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.

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.