Cardiology policy updates
Track new and updated Cardiology policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Evinacumab-dgnb (Evkeeza) IV infusion — Coverage Criteria for Homozygous Familial Hypercholesterolemia | Blue Cross Blue Shield - North Carolina | Clinical | Cardiology | Modified | Aug 1, 2026 |
| Inclisiran (Leqvio) subcutaneous injection — Medical necessity and site-of-care criteria | Blue Cross Blue Shield - North Carolina | Clinical | Cardiology | Modified | Aug 1, 2026 |
| Surgical Ventricular Restoration | Blue Cross Blue Shield - North Carolina | Clinical | Cardiology | Modified | Jun 8, 2026 |
| Transcatheter Closure of Ventricular Septal Defects | Blue Cross Blue Shield - North Carolina | Clinical | Cardiology | Modified | Mar 16, 2026 |
| Transcatheter Heart Valve Procedures | Blue Cross Blue Shield - North Carolina | Clinical | Cardiology | Modified | Jan 6, 2026 |
| Patent Foramen Ovale and Left Atrial Appendage Closure Devices | Blue Cross Blue Shield - North Carolina | Clinical | Cardiology | Modified | Jan 6, 2026 |
| Baroreflex Stimulation Devices | Blue Cross Blue Shield - North Carolina | Clinical | Cardiology | Modified | Jan 1, 2026 |
| Cardiac Monitoring Devices in the Outpatient Setting | Blue Cross Blue Shield - North Carolina | Clinical | Cardiology | Modified | Oct 1, 2025 |
| External Ambulatory Cardiac Monitors | Blue Cross Blue Shield - North Carolina | Clinical | Cardiology | Modified | Apr 16, 2025 |
| Leadless Cardiac Pacemakers — Coverage Criteria | Blue Cross Blue Shield - North Carolina | Clinical | Cardiology | Modified | Jul 1, 2024 |
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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.
OpenPayer by Trek Health — Policy intelligence for billing and revenue cycle teams.
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.