Excellus BlueCross BlueShield coverage policies

226 active Excellus BlueCross BlueShield policies in Backwork, grouped by policy type. Each policy page shows the codes the policy lists and links to the payer’s own copy.

Summary of the payer’s published policy. Not a coverage determination — confirm with Excellus BlueCross BlueShield before submitting.

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Policies

151–200 of 226, by type and title

PayerPolicy

EXCELLUS-7-01-59

Osteochondral Grafting of the Knee

EXCELLUS-7-01-59-FUTURE

Osteochondral Grafting of the Knee (Effective 2026-10-15)

EXCELLUS-11-01-13

Out-of-Network Services

EXCELLUS-4-01-10

Ovarian and Internal Iliac Vein Endovascular Occlusion as a Treatment of Pelvic Congestion Syndrome

EXCELLUS-7-01-58

Pacemakers and Cardiac Resynchronization Therapy (CRT) Devices

EXCELLUS-7-01-100

Pain Management Techniques for Knee Pain

EXCELLUS-7-02-01

Pancreas Transplant: (Pancreas Transplant Alone, Pancreas Transplant after Kidney Transplant, Simultaneous Pancreas Kidney Transplant): Islet Cell Transplant

EXCELLUS-3-01-18

Partial Hospitalization for Substance Use Disorders

EXCELLUS-1-01-08

Patient Lifts (e.g., Hoyer, Saralift, Seat Lift, Chair Mechanisms, and Ceiling Lifts)

EXCELLUS-1-01-08-FUTURE