Medical Policy Name | Summary of Changes |
|---|---|
| Durable Medical Equipment | Annual Review Medicare National Coverage Determinations Manual Chp 1 part 4, sec 280 Medicare Benefit Manual Chp 15 sec 110 Medicare Claims Processing Manual Chp 20 MLN SE1103 BCBSNC Evidence of Coverage Chp 4 No CMS Updates; Minor Revisions only |
| Foresee Home AMD Monitoring | Annual Review: Sent to external physician for review https://www.accessdata.fda.gov/cdrh_docs/pdf9/K091579.pdf MEDCAC Meeting - Age-related Macular Degeneration (11/29/2005) (cms.gov) External Physician Reviewed and did not recommend any changes; Minor Revisions only |
| Investigational (Experimental) Services | Annual Review Medicare Claims Manual Chp 32 sec 68 & 69 Blue Medicare EOC Chp 4 sec 3.1 BCBSNC MCP: Investigational (Experimental) Services Medicare Managed Care Manual Chp 4 sec 10.7.2 & 90.5 CMS Manual System 100-02 Transmittal 198 MLN Matters MM8921 Medicare Benefit Manual Chp 14 sec 20 No CMS Updates. Minor Revisions only |
| Mitral Valve Transcatheter Edge to Edge Repair | Annual Review Final Decision Memorandum for Transcatheter Mitral Valve Repair (TMVR) (CAG-00438R) No CMS Updates; Minor Revisions only |
| Refractive Surgical Procedures | Annual Review NCD 80.7 American Academy of Ophthalmology Refractive Errors and Refractive Surgery Preferred Practice Pattern 2017 External Physician Reviewed: did not recommend any changes; Minor Revisions only; Removed 65765 epikeratophakia under applicable codes; Updated reference #2 to reflect updated link |
| Rehabilitation Therapy | Annual Review Medicare Benefit Policy Manual Chp 1 sec 110 No CMS Updates. Minor Revisions only Added the following statement to the beginning of policy: “This policy was implemented in the absence of National Coverage Determinations (NCD) or Local Coverage Determinations (LCD) coverage criteria.” Statement added to align with the 2024 CMS Final Rule. |
| Temporomandibular Joint Surgery | Annual Review BCBSNC Corporate Medical Policy “Temporomandibular Joint Dysfunction (TMJD) Treatment” No CMS Updates. Minor Revisions only |
| Upper Limb Prosthetics | Annual Review BCBSNC Corporate Medical Policy “Myoelectric Prosthetic Components for the Upper Limb” No CMS Updates. Additional reference added. Four (4) CPT codes added |
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.