Medicare Advantage Medical Policy Updates 07012025

Blue Cross and Blue Shield of Nebraska is proud to work with our provider network to serve your patients, our members. We are updating several medical policies. Please review the changes and effective dates outlined here:

Medicare Advantage M.15 Procedures Following NCD, LCD or Interqual 

Effective Date: 07/01/2025
Preauthorization Required: Yes

Policy Statement:

LCD: L39913 Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI/QCT)/Coronary Plaque Analysis (AI-CPA)
Codes Requiring Preauthorization: 0623T, 0624T, 0625T, 0626T

LCD: L39907 Micro-Invasive Glaucoma Surgery (MIGS)
Codes Requiring Preauthorization: 0671T
Note: 0449T, 0253T, 0450T, 0474T are already on the preauthorization list.