Coding and Reimbursement Policy Updates

Blue Cross Blue Shield of North Dakota regularly 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 are adopted and/or revised.

The following coding and reimbursement policies and resources have had information added or revised:

  • Qualified Healthcare Providers Allowed Amount Reductions
    • Added further information regarding allowing 100% of PPS for Medicaid Expansion product for Licensed Addiction Counselor (LAC), Licensed Clinical Social Worker (LCSW) and Licensed Professional Clinical Counselor (LPCC). 
  • Durable Medical Equipment
    • Added information regarding exceptions to cap at purchase price for continual rental and clarification regarding take-home durable medical equipment (DME).
  • Home Health Services
    • Added information for Home Health Services furnished by telehealth.
  • Inpatient Immunizations (formerly Inpatient Vaccines)
    • Updated policy name to immunizations rather than vaccines to be more all-inclusive.  
    • Added language regarding paying outside of the inpatient per-diem.

To view reimbursement policies, visit our BCBSND website under the reimbursement policy search.