Coding and Reimbursement 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 updates will become effective on the website within the next 45 days.

The changes below can be referenced in the updated policy:

Medicaid Expansion- Correct Coding Policy update

• Correct Coding Policy- Medicaid Expansion
  • Format changes were made and updated verbiage.
  • Added PTP Code Pair Table.
  • Removed Evaluation and Management (E/M) Services section as this information will be called out in the new Evaluation and Management (E/M) policy once completed.
  • Removed Scope Edits section as this information can be found in our Multiple Procedures Payment Reduction for Medical and Surgical Services reimbursement policy.
  • Added additional cross references.

Commercial- Correct Coding Policy update

• Correct Coding Policy - Commercial
  • Format changes were made and updated verbiage.
  • Removed Evaluation and Management (E/M) Services section as this information will be called out in the new Evaluation and Management (E/M) policy once completed.
  • Removed Scope Edits section as this information can be found in our Multiple Procedures Payment Reduction for Medical and Surgical Services reimbursement policy.
  • Added additional Cross References.

Questions?
Contact the Provider Services phone number on the back of the BCBSND member ID card.