This applies to both Commercial and Medicaid Expansion
Blue Cross Blue Shield of North Dakota (BCBSND) regularly develops and revises coding and reimbursement policies 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.
BCBSND has removed the Medically Unlikely Editing (MUE) editing for Outpatient Non EAPG claims on April 7, 2022, which previously had an effective date of April 1, 2022. BCBSND will be reprocessing claims for this timeframe. The following coding and reimbursement policy has been revised and is available at https://www.bcbsnd.com/providers/policies-precertification/reimbursement-policy/correct-coding-guidelines.