Key Coding Updates: Telehealth, QHP Reimbursement and Breast Biopsy Guidelines

This applies to both Commercial and Medicaid Expansion

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 policies will have updates

• Telehealth Services (Reimbursement Policy) | BCBSND
  • Added back deleted telehealth codes (99441, 99442, 99443) with the date it was previously deleted.
  • Also added Digital medicine’s rise brings coding questions. AMA has answers. | American Medical Association link to references section.
• Qualified Healthcare Provider’s Allowed Amount Reductions | BCBSND
  • Added H2015 to allow at 100% for Medicaid Expansion for Licensed Addiction Counselor (LAC), Licensed Associate Professional Counselor (LAPC), Licensed Clinical Social Worker (LCSW), Licensed Professional Clinical Counselors (LPCC), Licensed Master Social Worker (LMSW), Licensed Professional Counselor (LPC)

The following reimbursement policy will have updates for August 12, 2025.

• Coding and Billing Guidelines for Breast Biopsies | BCBSND
  • Annual review completed.
  • Removed American College of Radiology – Breast Imaging FAQ’s reference and quote as this webpage is no longer active.
  • The quote was replaced with similar guidance from CMS regarding the use of CPT code 19081 when a percutaneous breast biopsy is performed using both stereotactic and tomosynthesis imaging, as well as, performing a follow-up mammogram performed post tomosynthesis-guided breast biopsy will be considered part of the procedure and is not separately payable.

Questions?
We are here for you. Contact the appropriate Provider Service Center:

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