09/15/2025
[Duplicate] BCBSM/BCN
Publications
July 2025 Issue Available HERE.
A Few Articles You Will Want to Check Out:
- Reminder: Follow these requirements when billing for noncovered services
- Clinical editing updates: IMRT billing rules; sequela codes; clinical editing portal; add-on code G2211
- Update: Medicare Advantage prior authorization requests submitted through NovoLogix must be submitted through different application, starting Aug. 1
- Answers to questions about changes to requirements for pain management procedures for our Medicare Advantage members
- Submit clinical documentation through Medical and Pharmacy Drug PA Portal
- Starting Oct. 6, submit prior authorization requests for FEP members through the e-referral system
- Pharmacy news roundup
- Starting Sept. 1, we’ll change how we pay for certain medications for most Blue Cross, BCN commercial members
- We’re changing how we manage self-administered hemophilia products for most Blue Cross, BCN commercial members, starting Sept. 1
- Webinars for physicians, coders focus on documentation, coding
- Reminder: Participating providers may only collect applicable deductibles, copayments from members upfront
- 2025 HCPCS 2nd-quarter update: New, deleted codes
- HCPCS replacement codes established, effective July 1, 2025
- Billing chart: Blue Cross highlights medical, benefit policy changes
July/August Bi-Monthly Issue Available HERE.
A Few Articles You Will Want to Check Out:
- Medical policy updates (Page 14)
- Behavioral health providers shouldn’t submit claims for behavioral health collaborative care services (Page 18)
- Pharmacy news roundup (Page 21)
- Bill HCPCS code J3490 for Depo-Provera for commercial members (Page 22)
- HelpScript enrollment service for manufacturer copay assistance will start July 1 for select medical benefit drugs for some BCN commercial members (Page 22)
- We’re changing how we cover Revlimid, starting August 1 (Page 24)
- Fees for new telemedicine E/M procedure codes to start July 1 (Page 25)
- 2025 billing changes affect provider-delivered care management services (Page 27)
- Claims status inquiry process (Page 28)
- Reminder: Follow correct billing guidelines when submitting claims for secondary payment (Page 31)
- Coding corner: Acute conditions not typically managed in office setting (Page 32)
- Clinical editing updates (Page 33)
- Medicare Advantage members can request a non-emergency transfer from one acute care facility to another at any time (Page 35)
- Preview questionnaires and medical necessity criteria (Page 39)