The Provider Manual December 2020 updates include changes in the following chapters:
Claim Submission
- Timeframe for Claim Submission
Documentation
- Evaluation and Management (E/M) Documentation Requirements
Documentation Removed
(Information is now available through the Availity Provider Portal)
- Documentation Guide for InterQual- Behavioral Health
- Behavioral Interventions for the treatment of Autism
- Child Psychiatric Residential Treatment Program
- Psychiatric Partial Hospital Program
- Substance Use Disorder Residential Treatment Program
- Substance Use Disorder Partial Hospital Program
- Adult Psychiatric Residential Treatment Program
Reimbursement & Billing Guidelines
The following chapters have been updated or relocated due to new reimbursement policies or notices:
- All Patient Refined -Diagnosis Related Groups (APR-DRG)
- Acute Inpatient (APR-DRGS) Hospital Billing
- Behavioral Health Inpatient Acute (APR DRGS)- Institutional Billing
New chapter additions
- Enhanced Ambulatory Patient Group (EAPG)
To view the updated Provider Manual, please visit
https://www.bcbsnd.com/content/dam/bcbsnd/documents/manuals/provider-manual-full.pdf
For reimbursement policies, please visit our website at www.BCBSND.com.
Reimbursement notices are found in our fee schedule portal at https://id.BCBSND.com/nidp/idff/sso?id=BCBSNDfeeschedule&sid=0&option=credential&sid=0&target=https://feeschedules.bcbsnd.com/feeschedule.