Skip to main content
Shop Plans Learn more about our coverage options including health, Medicare, dental and vision options for you, your family or your employees. Get Started Individual & Family Medicare Employer Vision Dental International Travel Find Care FAQ Blog Members Stay on top of your health care with helpful member resources. Members Home Medicare Health Dental Vision Find Care Member Knowledge Center Member Forms Medicare Forms Library Make a Payment Federal Employees Student Blue Healthy Blue Providers Access tools, policies and the latest information to help you care for our members. Providers Home Network Participation Networks & Programs Claims, Appeals & Inquiries Prior Authorization Services & CPT codes Prescription Drug Search Policies, Guidelines & Codes Provider News Provider FAQ Contact Us Employers Learn about our coverage options for small and large employers, and access tools and resources for your group. Employers Home Shop Employer Plans Employer Portal Support Member Forms & Resources Find Care Blog Agents Access the tools you need: rate quotes, applications, forms, the latest industry news, marketing materials and more. Agents Home Agent Services Check Eligibility Find Care Member Forms & Resources Medicare Forms Library
Contact Us
Log In
I am ... Please select A member A provider An employer An agent
Log in to Agent Services
Log in to Employer Services Register for Employer Services I'm registered but need portal access
Username Forgot username? Continue to Log In Register for Blue Connect Need help? Learn how to log in.
Log in to Blue e Register for Blue e Log in to Dental Blue
Back
Medical Policy Update for March 31, 2023
Medical GuidelinesReason for Update
Bronchial ThermoplastyDescription and References updated. Specialty Matched Consultant Advisory Panel review 3/2023. Medical Director review 3/2023. No change to policy statement.
Cardiovascular Disease Risk Assessment AHS – G2050Updated Billing/Coding section to add code 0377U effective 4/1/23.
Convection-Enhanced Delivery of Therapeutic Agents to the BrainSpecialty Matched Consultant Advisory Panel review 3/15/2023. Updated description section and references. No change to policy statement.
Cord Blood as a Source of Stem CellsSpecialty Matched Consultant Advisory Panel review 3/15/2023. Added reference for U.S. Food and Drug Administration (FDA). No change to policy statement.
Electromagnetic Navigation BronchoscopySpecialty Matched Consultant Advisory Panel review 3/2023. Policy guidelines and Regulatory status updated.  References added. Medical Director review 3/2023. No change to policy statement.
Endobronchial ValvesReferences updated. Specialty Matched Consultant Advisory Panel review 3/2023. Medical Director review 3/2023. No change to policy statement.
Esophageal Pathology Testing AHS – M2171Updated Billing/Coding section to add code 0386U effective 4/1/23.
Gene Expression Profiling and Protein Biomarkers for Prostate Cancer AHS - M2166Off cycle review by Avalon. Updated policy guidelines and references. Deleted related policies section. Clarified “when covered” section and added coverage criteria for 4Kscore. Clarified and edited notes 2-5. Added PLA codes 0339U, 0359U to Billing/Coding section. Medical Director review 1/2023.
Heart-Lung TransplantationMinor updates to description. Related policies added. References added. Specialty Matched Consultant Advisory Panel review 3/2023.  Medical Director review 3/2023.
Hormone Pellet Implantation for Treatment of Menopause Related SymptomsSpecialty Matched Consultant Advisory Panel review 3/2023. Medical Director Review 3/2023. Related Policies section updated. References updated. No change to policy statement. 
Laboratory Procedures Medical Policy AHS - R2162Updated Billing/Coding section to add codes 0372U, 0375U, 0376U, 0378U, 0381U, 0382U, 0383U, 0384U and 0385U effective 4/1/2023.
Liquid Biopsy  AHS-G2054Added PLA code 0368U to Billing/Coding section.
Lung and Lobar Lung TransplantationDescription and references updated. Specialty Matched Consultant Advisory Panel review 3/2023. Medical Director review 3/2023. No change to policy statement.
Lung Volume Reduction SurgeryReferences added. When covered section updated for clarity. Specialty Matched Consultant Advisory Panel review 3/2023. Medical Director review 3/2023. No change to policy statement.
Maternal and Fetal DiagnosticsReferences updated. Specialty Matched Consultant Advisory Panel review 3/2023. Medical Director review 3/2023. Related policies updated.  No change to policy statement. 
Microsatellite Instability and Tumor Mutational Burden Testing AHS-M2178Added PLA code 0379U to Billing/Coding section.
Minimal Residual Disease (MRD) AHS-M2175Added PLA code 0364U to Billing/Coding section.
Monoclonal Antibody Imaging for Prostate CancerSpecialty Matched Consultant Advisory Panel review 3/15/2023. Reference added. No change to policy statement.
Noninvasive Respiratory Assist DevicesDescription and Billing/coding sections updated for clarity. References added. Updated coverage criteria for Severe COPD for clarity. Specialty Matched Consultant Advisory Panel review 3/2023. Medical Director review 3/2023. No change to policy statement.
Oncologic Applications of Photodynamic Therapy, Including Barrett’s EsophagusSpecialty Matched Consultant Advisory Panel review 3/15/2023. References added. No change to policy statement.
Oscillatory Devices for the Treatment of Respiratory ConditionsRegulatory status and policy guidelines updated. References added. Specialty Matched Consultant Advisory Panel review 3/2023.  Medical Director review 3/2023. No changes to policy statement.
Ovarian and Internal Iliac Vein Embolization, Ablation and SclerotherapyDescription updated for clarity. References updated. Specialty Matched Consultant Advisory Panel review 3/2023. Medical Director Review 3/2023. No change to policy statement.
Pathogen Panel Testing AHS – G2149Updated Billing/Coding section to add codes 0369U, 0370U, 0371U, 0373U, and 0374U effective 4/1/2023.
Pharmacogenetics Testing AHS – M2021Updated Billing/Coding section to add code 0380U effective 4/1/23.
Phrenic Nerve Stimulation for Central Sleep ApneaDescription and policy guidelines updated. References added. Specialty Matched Consultant Advisory Panel 3/2023.  Medical Director review 3/2023. No changes to policy statement.
Progesterone Therapy in High Risk PregnanciesDescription, Regulatory Status, Policy Guidelines, and Reference sections updated.  Specialty Matched Consultant Advisory Panel review 3/2023. Medical Director review 3/2023. No change to policy statement.
Skin and Soft Tissue SubstitutesBilling/Coding section updated to add A2019, A2020, A2021, Q4265, Q4266, Q4267, Q4268, Q4269, Q4270, and Q4271, effective 4/1/2023.
Sleep Apnea: Diagnosis and Medical ManagementAdded new code A7049 to Billing/Coding section effective 4/1/2023. 

 

 

 

 

Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.

Information in other languages: Español   中文   Tiếng Việt   한국어   Français   العَرَبِيَّة   Hmoob   ру́сский   Tagalog   ગુજરાતી   ភាសាខ្មែរ   Deutsch   हिन्दी   ລາວ   日本語

© 2025 Blue Cross and Blue Shield of North Carolina. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. All other marks and names are property of their respective owners. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association.