Medicare Advantage Medical Policy Updates

Effective June 1, 2026

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:

New Medical Policies for Medicare Advantage

Medical Policy Name: Quantitative Electroencephalography as a Diagnostic Aid for ADHD, Cognitive Impairment or Autism
Effective Date: 06/01/2026
Preauthorization Required: No

Codes: 95812 95813 95816 95819

  1. Quantitative electroencephalographic-based assessment of the theta/beta ratio is considered investigational as a diagnostic aid for attention-deficit/hyperactivity disorder.
  2. Quantitative electroencephalographic-based assessment is considered investigational as a diagnostic aid for cognitive impairment.
  3. Quantitative electroencephalographic-based assessment is considered investigational as a diagnostic aid for autism spectrum disorder.
Medical Policy Name: Sinus Surgery
Effective Date: 06/01/2026
Preauthorization Required: Yes

Codes: 31254 31255 31256 31267 31276

InterQual Criteria will be utilized 

Medical Policy Name: Bone Mineral Density   (These are not the routine and standard of care Dexa Scans)
Effective Date: 06/01/2026
Preauthorization Required: Yes

Codes: 78350 78351 77089 77090 77091 77092

  1. Bone density study using single or dual photon absorptiometry (78350, 78351) is Investigational.
  2. Trabecular Bone Scores (77089, 77090, 77091, 77092) are considered Investigational.
Medical Policy Name: Pneumatic Compression
Effective Date: 06/01/2026
Preauthorization Required: Yes 

Codes: E0650, E0651, E0652, E0655, E0656, E0657, E0660, E0665, E0666, E0667, E0668, E0669, E0670, E0671, E0672, E0673

NCD 280.6
https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=225&ncdver=1&bc=0

 
Shop Plans
Member Support
Partner Resources
About Us