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Medical Policy Update: B-Type Natriuretic Peptide in Congestive Heart Failure

Effective January 17, 2018, Horizon Blue Cross Blue Shield of New Jersey will change the way we consider claims for the measurement of brain natriuretic peptide (BNP) levels to assist in diagnosing congestive heart failure in Horizon BCBSNJ Medicare Advantage (MA) plan members.

The guidelines of our medical policy, B-Type Natriuretic Peptide in Congestive Heart Failure, identify when the measurement of BNP levels to assist in the diagnosis of congestive heart failure is considered medically necessary.

We encourage you to review this policy in our Medical Policy Manual.


Based on the guidelines of our medical policy, B-Type Natriuretic Peptide in Congestive Heart Failure AND the submitted diagnosis code, CPT® code 83880 included on claims for services provided on and after January 17, 2018 to patients enrolled in Horizon BCBSNJ MA plans may be denied as not medically necessary.

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims for dates of service on and after January 17, 2018.

CPT® is a registered mark of the American Medical Association.

Published on: December 18, 2017, 11:58 a.m. ET
Last updated on: December 18, 2017, 11:59 a.m. ET