Tagged with CPT Coding

Aetna – Clinical Payment and Coding Policy Changes

Effective September 1, Aetna will implement changes to its clinical payment and coding policy for several services and procedures, and will also implement several changes to its CPT® codes assigned to Enhanced Groupings (AEG) and/or Coventry Enhanced Groupings (CEG).

UnitedHealthcare – Coordinated Commercial Reimbursement Policy Updates

Beginning in July, UnitedHealthcare (UHC) will make changes to some commercial reimbursement policies, including after hours and weekend care, intraoperative neuromonitoring, and its professional and technical component policy for duplicate or repeat services of global test only.

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.