Pulmonology policy updates
Track new and updated Pulmonology policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Tezepelumab-ekko (Tezspire) — Notification (coverage criteria) | Blue Cross Blue Shield - North Carolina | Clinical | Pulmonology | Modified | Jul 1, 2026 |
| Interleukin-5 Antagonists (benralizumab, depemokimab, mepolizumab, reslizumab) — Notification / Coverage Criteria | Blue Cross Blue Shield - North Carolina | Clinical | Pulmonology | Modified | Jul 1, 2026 |
| Endobronchial Valves | Blue Cross Blue Shield - North Carolina | Clinical | Pulmonology | Modified | Mar 29, 2026 |
| Bronchial Thermoplasty | Blue Cross Blue Shield - North Carolina | Clinical | Pulmonology | Modified | Mar 1, 2026 |
| Lung Volume Reduction Surgery | Blue Cross Blue Shield - North Carolina | Clinical | Pulmonology | Modified | Mar 1, 2026 |
| Electromagnetic Navigation Bronchoscopy (ENB) Coverage Policy | Blue Cross Blue Shield - North Carolina | Clinical | Pulmonology | Modified | Mar 1, 2026 |
| Oscillatory Devices for the Treatment of Respiratory Conditions | Blue Cross Blue Shield - North Carolina | Clinical | Pulmonology | Modified | Aug 24, 2021 |
| Molecular Testing for Pulmonary Disease | Blue Cross Blue Shield - North Carolina | Clinical | Pulmonology | Modified | Apr 1, 2019 |
| Noninvasive Respiratory Assist Devices (home use) | Blue Cross Blue Shield - North Carolina | Clinical | Pulmonology | Modified | Jan 1, 2019 |
| Bi-level Positive Airway Pressure (BIPAP) (E0470/E0471) Prior Authorization Request Form | Blue Cross Blue Shield - North Carolina | Clinical | Pulmonology | Modified | — |
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OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.
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Coverage data is sourced from publicly available payer medical policy documents and updated as payers publish revisions. Read more about where our data comes from. Always consult the primary payer source for clinical decision-making.