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Blue Cross NC Home Providers Policies, guidelines and codes Commercial Medical Policy Update April 15, 2026 Commercial Medical Policy Update April 15, 2026

 

Medical Guidelines	Reason for Update
Ablative Techniques for the Myolysis of Uterine Fibroids	Descriptions and policy guidelines updated. Removed FDA information from billing/coding section as FDA status is addressed under Regulatory Status. References added. Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026. No change to policy statement.
Bone Mineral Density Studies	Description and policy guidelines updated. References updated. Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026. No change to Policy statement.
Bronchial Thermoplasty	References updated. Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026. No change to policy statement.
Capsule Endoscopy, Wireless	Description, Regulatory Status and References updated. Specialty Matched Consultant Advisory Panel 3/2026. Medical Director review 3/2026.
Chromoendoscopy as an Adjunct to Colonoscopy	Description, Policy Guidelines and References updated. Specialty Matched Consultant Advisory Panel 3/2026. Medical Director review 3/2026.
Computed Tomography to Detect Coronary Artery Calcification	Policy archived.
Confocal Laser Endomicroscopy	References updated. Specialty Matched Consultant Advisory Panel 3/2026. Medical Director review 3/2026.
Convection-Enhanced Delivery of Therapeutic Agents to the Brain	Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026. Reference added.
Cord Blood as a Source of Stem Cells	Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026. References and Regulatory sections updated. Removed referenced medical policy, Hematopoietic Cell Transplantation, from Policy Guidelines and created Related Policy section.
Dry Needling of Myofascial Trigger Points	Policy archived.
Electrogastrography, Cutaneous	References updated. Specialty Matched Consultant Advisory Panel 3/2026. Medical Director review 3/2026.
Electromagnetic Navigation Bronchoscopy	Description, Policy Guidelines, and References updated. Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026. No change to policy statement.
Endobronchial Valves	Description, Policy Guidelines, and References updated. Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026. No change to policy statement.
Enteral Nutrition	References updated. Specialty Matched Consultant Advisory Panel 3/2026. Medical Director review 3/2026.
Epidural Steroid Injections for Back Pain	Policy archived.
Esophageal pH Monitoring	References updated. Specialty Matched Consultant Advisory Panel 3/2026. Medical Director review 3/2026.
Extracorporeal Photopheresis	Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026.  The word “patient” changed to “individual” throughout policy.   Regulatory Status section updated.  References added. No change to policy statement.
Gastric Electrical Stimulation	References updated. Specialty Matched Consultant Advisory Panel 3/2026. Medical Director review 3/2026.
Gastroesophageal Reflux Disease, Transendoscopic Therapies	Policy Guidelines and References updated. Specialty Matched Consultant Advisory Panel 3/2026. Medical Director review 3/2026.
Heart-Lung Transplantation	Description updated. References added. Specialty Matched Consultant Advisory Panel review 3/2026.  Medical Director review 3/2026. No change to policy statement.
Hematopoietic Cell Transplantation	Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026. The word “patient” changed to “individual” throughout policy.  References added. Policy Guidelines updated without change to policy’s intent.
Hormone Pellet Implantation for Treatment of Menopause Related Symptoms	Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director Review 3/2026. References updated. No change to policy statement.
Infertility Diagnosis and Treatment – B0006	References updated. Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 9/2026.  Removed codes 54900, 54901, 55300, 55400, 58970, 58974, 58976, 76948, 89250, 89251, 89253, 89254, 89255, 89258, 89259, 89268, 89272, 89280, 89281, 89290, 89291, 89329, 89335, 89337, 89342, 89343, 89344, 89346, 89352, 89353, 89354,  89356, S4011, S4013, S4014, S4015, S4016, S4017, S4018, S4020, S4021, S4022, S4023, S4025, S4026, S4027, S4028, S4030, S4031, S4037, S4040 from Billing/Coding section. Please refer to the Member's Benefit Booklet for availability of benefits. No change to policy statement.
Lung and Lobar Lung Transplantation	Description updated. References added. Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026. No change to policy statement.
Lung Volume Reduction Surgery	Description and Policy Guidelines updated. References added. Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026. No change to policy statement.
Maternal and Fetal Diagnostics	References updated. Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026. No change to policy statement.
Meniscal Allografts and Other Meniscal Implants	Policy archived.
Monoclonal Antibody Imaging for Prostate Cancer	Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026.  References added.
Noninvasive Respiratory Assist Devices	Minor grammar edits made throughout policy. References added. Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026. No change to policy statement.
Oncologic Applications of Photodynamic Therapy, Including Barrett’s Esophagus	Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026. Added one Related Policy.  References added.
Oscillatory Devices for the Treatment of Respiratory Conditions	Updated Description and Regulatory Status. References added. Specialty Matched Consultant Advisory Panel review 3/2026.  Medical Director review 3/2026. No changes to policy statement.
Ovarian and Internal Iliac Vein Embolization, Ablation and Sclerotherapy	Regulatory status updated. References added. Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director Review 3/2026. No change to policy statement.
Pancreas Transplant	Description and References sections updated. Specialty Matched Consultant Advisory Panel 3/2026. Medical Director review 3/2026.
Peroral Endoscopic Myotomy for Treatment of Esophageal Achalasia	References updated. Specialty Matched Consultant Advisory Panel 3/2026. Medical Director review 3/2026.
Phrenic Nerve Stimulation for Central Sleep Apnea	References added. Specialty Matched Consultant Advisory Panel 3/2026.  Medical Director review 3/2026. No changes to policy statement.
Polysomnography for Non‒Respiratory Sleep Disorders	Policy archived.
Sleep Apnea: Diagnosis and Medical Management	References added. Added the following statement to Billing/Coding section: “Custom fabricated OSA devices should be billed using code E0486.” Specialty Matched Consultant Advisory Panel Review 3/2026. Medical Director Review 3/2026. No change to policy statement.
Small Bowel, Small Bowel with Liver, or Multivisceral Transplant	References updated. Specialty Matched Consultant Advisory Panel 3/2026. Medical Director review 3/2026.
Surgery for Femoroacetabular Impingement	Policy archived.
Surgery for Obstructive Sleep Apnea and Upper Airway Resistance Syndrome	Policy Guidelines updated. References added. Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026. No change to policy statement.
Transanal Endoscopic Microsurgery (TEMS)	Policy Guidelines and References updated. Specialty Matched Consultant Advisory Panel 3/2026. Medical Director review 3/2026.
Tumor Treatment Fields Therapy	Specialty Matched Consultant Advisory Panel review 3/2026. Medical Director review 3/2026.  Added 3 Related Policies.  References added. Description, Regulatory Status, and Policy Guidelines sections updated to include FDA indication for non-small cell lung cancer.  No change to policy statement.
Vertebral Axial Decompression (VAD-X)	Policy archived.