Reimbursement policy update: Additional revenue codes will require CPT/HCPCS codes effective December 15

As a reminder, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) requires revenue codes to be submitted with an appropriate corresponding CPT® or HCPCS code, consistent with Centers for Medicare & Medicaid Services (CMS), Uniform Billing Editor (UBE) and UB-04 billing requirements.

Effective December 15, 2026, Blue Cross NC is updating the Revenue Codes Requiring Procedure Codes reimbursement policy to add revenue codes 0275, 0276 and 0278 to the list of additional revenue codes that require a corresponding CPT® or HCPCS code. Revenue codes submitted with an inappropriate CPT® or HCPCS code will not be eligible for reimbursement.

Blue Cross NC enforces the revenue code list included in the most current CMS Outpatient Code Editor (OCE) edit. Providers should also refer to the policy reference section for Blue Cross NC’s additional revenue code list.

For Commercial providers: This update also applies to the Billing and Coding section of the Commercial reimbursement policy.

For additional details, review the applicable policy notification:

• Commercial: Commercial policy notification
• Medicare Advantage: Medicare policy notification

Applicability

This policy applies to Commercial, Inter-Plan Program (IPP) Host, Medicare Advantage and Federal Employee Program (FEP). It does not apply to IPP Home.