NOTE** Review policies online to determine if the policy applies to both BCBSND Commercial and/or Medicaid Expansion Plans.
The below reimbursement policies will be revised. The revisions will become effective on January 1, 2023.
- Correct Coding Guidelines – Commercial
- Updates to verbiage and additional information regarding when it would be considered appropriate to bill an office/outpatient E/M service with a preventive E/M service.
- Updates to verbiage and additional information regarding when it would be considered appropriate to bill an office/outpatient E/M service with a preventive E/M service.
- Global Surgical Package
- Updates to verbiage-replacement of all instances of “specialty” with “specialty and sub-specialty”.
- Updates to verbiage-replacement of all instances of “specialty” with “specialty and sub-specialty”.
- Consultation Services
- Removal of CPT codes 99241 and 99251.
- These codes will be deleted due to a decision made by the American Medical Association (AMA).
- These codes will be deleted due to a decision made by the American Medical Association (AMA).
- Removal of CPT codes 99241 and 99251.
- Observation Services
- Removal of CPT codes 99217-99220 and 99224-99226
- These codes will be deleted due to a decision made by the American Medical Association (AMA).
- These codes will be deleted due to a decision made by the American Medical Association (AMA).
- Removal of CPT codes 99217-99220 and 99224-99226
- Coding and Billing Guidelines for Emergency Department
- Removed references to level of history and examination.
- These references will be deleted and only the level of medical decision-making will be used when selecting the appropriate code. Added information about time not being a descriptive component for the emergency department levels of E/M services.
- Removed references to level of history and examination.
