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Blue Cross NC Home Providers Policies, guidelines and codes Commercial Medical Policy Update March 11, 2026 Commercial Medical Policy Update March 11, 2026

 

Medical Guidelines	Reason for Update
Ablation and Neural Therapy Procedures for Headache and Pain Management	References updated. Removed “Facet Joint Denervation” from Related Policies. Regulatory Status updated.  Policy Guidelines updated. No change to policy intent. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026.
Ambulance and Medical Transport Services	Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director Review 2/2026. No change to policy statement. Removing codes A0080, A0090, A0100, A0120, A0160, A0170, A0180, A0190, A0200, A0210, A0888, S0209, S0215 from Billing/coding section. Please refer to the Member's Benefit Booklet for availability of benefits.
Balloon Ostial Dilation (Balloon Sinuplasty)	Regulatory Status and Policy Guidelines sections.   References updated.  When Covered Section updated with new criterion which states, “The management of nasal airway obstruction in individuals who do not otherwise meet criteria for recurrent acute or chronic sinusitis.”  No change to policy intent.  Medical Director review 2/2026.  Specialty Matched Consultant Advisory Panel review 2/2026.
Bone Morphogenetic Protein	References updated. Removed “Lumbar Spine Procedures” from related policies.  Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026.
Chelation Therapy	Minor updates to Description and Policy Guidelines. References updated. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director Review 2/2026. No change to policy statement.
Clinical Trial Services	References updated. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026. No change to policy. Removing codes S9992, S9994, and S9996 from Billing/Coding section. Please refer to the Member's Benefit Booklet for availability of benefits.
Complementary and Alternative Medicine	Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026.  Please refer to the Member's Benefit Booklet for availability of benefits. Archive policy.
Dynamic Posturography	References updated. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026.
Electrical Stimulation for the Treatment of Arthritis	References updated. No change to policy statement. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director Review 2/2026.
Hemodialysis Treatment for ESRD	References updated. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026.
Infusion Therapy in the Home	References updated. Specialty Matched Consultant Advisory Panel review 2/2025. Medical Director review 2/2025. No change to policy statement. Removing codes S5035, S5036, and S5518 from Billing/Coding section. Please refer to the Member's Benefit Booklet for availability of benefits.
Inpatient Interfacility Transfers	References updated. No change to policy statement. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026.
Intradialytic Parenteral Nutrition	References updated. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026.
Microarray-Based Gene Expression Profile Testing for Multiple Myeloma Risk Stratification AHS-B0002	Archive policy.
Microprocessor-Controlled Prostheses for the Lower Limb	References updated. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026.
Observation Room Services	References updated. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026. No change to policy statement.
Orthopedic Applications of Stem Cell Therapy	References updated. Related policies updated to remove “Autologous Chondrocyte Implantation.”  Background updated to remove Map3®, manufactor is no long making per FDA letter dated 08/05/2020. Policy guidelines updated. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026.
Orthotics	References updated. Specialty Matched Consultant Advisory review 2/2026. Medical Director review 2/2026.
Powered Exoskeleton for Ambulation in Patients with Lower Limb Disabilities	References updated. Regulatory Status updated. Specialty Matched Consultant Advisory Panel review 2/2026. Medial Director review 2/2026.
Private Duty Nursing Services	References updated. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026. No change to policy statement.
Psychiatric Intensive Outpatient Programs	Updated When Covered Section to remove “There is documentation of evaluation within 3 treatment days of admission by a psychiatrist or psychiatrist extender who remains available as medically indicated for face-to-face evaluations.”
Remote Therapeutic and Physiologic Monitoring	References updated. Medical Director Review 2/2026. Specialty Matched Consultant Panel review 2/2026. No change to policy statement.
Renal (Kidney) Transplantation	Description, Policy Guidelines and References updated. Specialty Matched Specialty Advisory Panel review 2/2026. Medical Director review 2/2026.
Renal Denervation as a Treatment of Hypertension	Policy Guidelines and References sections updated. Specialty Matched Advisory Panel review 2/2026. Medical Director review 2/2026.
Semi-Implantable and Fully Implantable Middle Ear Hearing Aid	Regulatory Status section updated. Updated References.  Specialty Matched Consultant Review 2/2026. Medical Director review 2/2026.
Skilled Nursing Facility Care	References updated. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026. No change to policy statement.
Skilled Nursing Services	References updated. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director Review 2/2026. No change to policy statement. Removing codes 99507 and 99510 from Billing/Coding section. Please refer to the Member's Benefit Booklet for availability of benefits.
Subtalar Arthroereisis	References updated. Description section updated to add additional FDA approved Subtalar Implants. Minor wording edits to Policy Guidelines. Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026.
Surgical Treatment of Sinus Disease	References updated.  Medical Director review 2/2026.  Specialty Matched Consultant Advisory Panel review 2/2026.
Synthetic Cartilage Implants for Joint Pain	References updated. Removed related policies “Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions” and “Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions”. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026.
Three Dimensional Printed Orthopedic Implants	References updated. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026.
Ultrasound Accelerated Fracture Healing Device	References updated. Description section updated to add contributing factors to non union. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026.
Vestibular Function Testing	References updated. Specialty Matched Consultant Advisory Panel review 2/2026. Medical Director review 2/2026.