Tagged with BCBS Blue Cross Blue Shield

Anthem Adopts MCG Care Guidelines

Anthem’s behavioral health medical policies and clinical guidelines currently in place for reviewing of behavioral health services, will be replaced by the MCG Care Guidelines 22nd edition Behavioral Health guidelines.

Anthem BCBS AIM Radiation, Oncology Clinical Guidelines Updates

Anthem Blue Cross Blue Shield (BCBS) published a notice stating that effective with dates of service on and after July 1st a separate company, AIM Specialty Health (AIM), will apply AIM’s Radiation Oncology Clinical Appropriateness Guidelines to precertification requests for certain services.

Rhode Island – BCBSRI CPT and HCPCS Level II Code Changes

Blue Cross and Blue Shield of Rhode Island (BCBSRI) has updated its claims processing system. These updates became effective April 1 and include Category II performance measurement tracking codes and Category III temporary codes for emerging technology.

New Hampshire – Anthem BCBS Reimbursement Policy Update

Anthem Blue Cross Blue Shield of New Hampshire (BCBSNH) has released updates to its current reimbursement policy for E&M services and related modifiers 25 and 57 professional reimbursement, facility claims requiring additional documentation policy, as well as its pharmaceutical waste facility reimbursement policy.

Massachusetts – BCBSMA Claims, Coding, Payment Updates

Blue Cross Blue Shield of Massachusetts (BCBSMA) has released coding and payment updates for certain procedures and services, including venipuncture reported with labs or E&M service, interim caries arresting medicament, and others.