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Medical Policy Update: Identification of Microorganisms Using Nucleic Acid Probes

Effective April 20, 2021, Horizon BCBSNJ will change the way we consider certain professional claims based on an update to our medical policy, Identification of Microorganisms Using Nucleic Acid Probes.

Access our Medical Policy Manual to review this medical policy content.

Claims submitted for services provided on and after April 20, 2021 to members enrolled in Horizon BCBSNJ Medicare Advantage plans will be processed as follows:

  • Regardless of the submitted diagnosis code(s), the services represented by CPT® codes 0151U and 0225U will be denied as not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member, based on a national coverage determination or local coverage determination.

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

Published on: March 19, 2021, 16:10 p.m. ET
Last updated on: April 22, 2021, 05:27 a.m. ET