Coding and Reimbursement Policy Update

Blue Cross Blue Shield of North Dakota (BCBSND) continually develops and revises coding and reimbursement policies and resources in response to rapidly changing medical technology and updates to the coding sets.

Our commitment is to update the provider community as coding and reimbursement policies and guidelines are added, adopted, and/or revised.

The following coding and reimbursement policy has been updated:

• Psychiatric and Substance Use Services Guidelines
  • Added a note for Residential Treatment Centers (RTC) Services: Providers will not be reimbursed for date of discharge at the RTC level of care. Providers should reflect the true date of discharge in the through date section of the UB-04 Claim Form; however, should not bill for that date of service on the line level. If the services provided on the date of discharge are equivalent to a partial hospitalization program (PHP) or intensive outpatient program (IOP) level of care, that service can be billed on a separate outpatient claim. 

Also, an added reminder for providers to reference a previously published HealthCare News article regarding type of bill and patient status, which applies to the Medicaid Expansion line of business.

Questions?  
For additional questions contact the appropriate Provider Service Center:

• Commercial: 800-368-2312  
• Medicaid Expansion: 833-777-5779