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Medical policies and guidelines

Medical policies and guidelines

Find Commercial and Medicare medical policies, administrative and reimbursement guidelines for procedures, and correct coding guidance.

Medicare calendar year 2024 policy and technical changes

As a result of the calendar year (CY) 2024 policy and technical changes to the
Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly, changes have been made to the Blue Cross and Blue Shield of North Carolina Blue Medicare Advantage℠ medical policies.

Moving forward, if there is not a National Coverage Determination (NCD) or Local Coverage Determination (LCD) in existence for the service or procedure requested, Blue Cross and Blue Shield of North Carolina Blue Medicare Advantage will provide criteria that is publicly available and meets Centers for Medicare & Medicaid Services (CMS) guidelines for how criteria is established.

Visit the CMS Medicare Coverage Database (MCD) to search by keywords, codes, and document IDs.

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