Medical Guidelines | Reason for Update |
|---|---|
New policy developed. Autonomic nervous system (ANS) testing may be considered medically necessary when criteria are met. ANS testing using portable, automated devices is considered investigational. Medical Director review. Notification given 5/30/2023 for effective date 8/1/2023. | |
| Electrical Bone Growth Stimulation | Reference added. Minimal edits to Policy Guidelines to include updated definition of nonunion. Specialty Match Consultant Advisory Panel review 6/2023. |
Extracorporeal Shock Wave Treatment for Musculoskeletal Conditions and Wound Healing | Minimal formatting changes to the Description section. Update definition of nonunion in the Policy Guidelines. Specialty Matched Consultant Advisory Panel review 6/2023. Medical Director Review 6/2023. References updated. |
References updated. Specialty Matched Consultant Advisory Panel review 6/2023. Medical Director review 6/2023. | |
Added Status Code “I” to Reference added. Description section updated. Minor edits to policy guidelines. Specialty Matched Consultant Advisory Panel review 6/2023. Medical Director review 6/2023. | |
| Surgery for Femoroacetabular Impingement | Reference added. Minimal edits to description section. Minimal edits to Policy Guidelines. Specialty Matched Consultant Advisory Panel review 6/2023. Medical Director review 6/2023. |
| Vertebral Axial Decompression (VAD-X) | Reference added. Minor edits to Description section. Specialty Match Consultant Advisory Panel review 6/2023. Medical Director review 6/2023. |
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.