Correct Coding Guidelines – Commercial Update Notification

Blue Cross Blue Shield of North Dakota (BCBSND) wants to inform providers of a change to the Correct Coding Guidelines-Commercial reimbursement policy. This change will include information on how to correctly bill above the CMS Medically Unlikely Edits (MUE) value when appropriate. Additional information was added regarding non-EAPG claims. Non-EAPG claims will not process through standard MUE editing, however, they will be subject to the Payment Integrity MUE editing.

If you have any questions regarding the change, please contact the Provider Service Center at: 1-800-368-2312.