Update: The Facility Billing Guidelines update is effective April 3, 2026. This policy update was originally published February 1, 2026.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has updated our Facility Billing Guidelines reimbursement policy to include guidance regarding end-stage renal disease (ESRD) facility services. Effective April 3, 2026, to be eligible for reimbursement, procedures submitted with bill type 0720-072Z without condition code 84 must include a principal diagnosis of ESRD. If submitted with condition code 84, HCPCS code G0491 for acute kidney injury (AKI) must be appropriately reported.
Please see the related policy notification for more information.
This policy applies to commercial, Inter-Plan Program (IPP) Host, and Federal Employee Program (FEP). This does not apply to IPP Home. This is already applicable to Medicare Advantage.
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
© 2026 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.