CommercialCoverageHigh impact
2026 April Medical Policy Updates
BlueCross BlueShield of South Carolina·SC · Orthopedics, Family Medicine, Internal Medicine +2 more·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 20, 2026
Summary
BlueCross BlueShield of South Carolina issued comprehensive April 2026 medical policy updates including 6 new orthopedic arthroplasty and arthroscopy policies, archived multiple older policies, added new vaccine and prosthetic codes, and made coverage changes for lymphedema detection devices. Multiple policies received annual reviews with updated documentation requirements.
Action Required
By April 1, 2026: Billing team must update systems with new orthopedic policy numbers (CAM 771-776) replacing archived policies for hip, knee, and shoulder procedures. Add new prosthetic code L2221 for lower limb microprocessor devices. Update vaccine coding: CPT 90673 now limited to ages 9+ and add new meningococcal vaccine code 90624. Review lymphedema bioimpedance device claims (CAM 20182) as coverage changed from investigational to medically necessary. Verify all orthopedic procedures reference current policy numbers to prevent claim denials.