- Blue cross blue shield codes Modifiers — Refer to the Clinical Payment and Coding Policy page On Jan. You’ll need the full name of the health plan and the enrollment code below to enroll. 181 Hospital s room rate : 187 . C. These may include an underlying medical condition, a substance abuse Use Premera’s code check tool to check medical/dental codes to see if prior authorization is required. 68: $374. See Plan Brochure View an interactive plan summary book. Find your state and discover your local Blue Cross Blue Shield company that serves you directly. • Select Blue Cross Blue Shield of Kansas • Select BCBSKS Provider Secure Section (Blue Access) • Select organization from drop down menu Find your local Blue Cross and Blue Shield Health Insurance Company Newsroom | Health Professionals | Employers | Federal Employees | Public Policy Specialists . See the list of the designated medical and surgical services and select Members of the Federal Employee Blue Cross/Blue Shield Service Benefit Plan (FEP) These code sets are required by all health insurance carriers nation wide. Newly approved procedures will appear under the New Payable Procedures Blue Cross and Blue Shield of Minnesota and Blue Plus (Blue Cross) has developed reimbursement policies that provide coding and reimbursement requirements for healthcare services. 21: Self + 1 October 2022 Procedure Code and Fee Schedule Updates . Great benefits await with MyBlue ®. The table below shows prefix replacements. Within the previous Codes; A1C: 83036: Blood draw: 36415: Comprehensive metabolic panel: 80053: Drug screening: 80101, 80100: Hemoglobin: 85018, 85025, 88738: Lipid panel for any diagnosis: Blue Cross Blue Shield Global Core gives Blue Cross and Blue Shield of Vermont members access to their health care benefits wherever they go Prior Authorization Code Lists Virginia (excluding the Northern Virginia suburbs of Washington, D. The Health Plan has adopted eviCore’s . for Blue Cross commercial and Medicare Plus Blue members and indicates which entity manages prior authorizations. Search (enter keyword, CPT or HCPCS code, policy number, etc. Blue Cross & Blue Shield of Mississippi does not control such third party websites and is 2023 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option Section 5(f). Consistent with the CPT definition of the telephonic codes 98966-98968 and 99441-99443 and with certain telehealth codes, Blue Cross Blue Shield of Massachusetts will not reimburse for these services when a related evaluation and management (E/M) service has been provided: . Some code descriptions, CPT ® and HCPCS, specify a time parameter for which the code should The online Medical Policy Reference Manual contains approved medical policies and operating procedures for all products offered by CareFirst. Blue Cross and Blue Shield of Illinois (BCBSIL) appreciates the care and attention you provide to our members. Sitemap | Professional Provider Manual Remittance Advice Remark Codes (offsite link) Dental Business Procedure Manual (offsite link) Dental Coverage Summary (offsite link) Blue Cross and Blue Shield of Kansas is an independent licensee of the Blue Cross Blue Shield Association. 76 Blue Cross Blue Shield Provider Phone Number Blue Cross Blue Shield Federal Phone Number. Find Care Near You with the Find a Doctor Tool. 4 You must be the contract holder or spouse, 18 or older, on an FEP Blue Focus plan to earn this reward. Newly approved procedures will appear under the New Payable Procedures heading. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. 43 Biweekly your share: $150. Select BCBS Provider. Blue Cross and Blue Shield companies' contract with doctors and health care professionals across the country. Premera Blue Cross Blue Shield of Alaska complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability Dental. Customer Service: Health Resources Enter Your Zip Code: Home | Customer Service | Health Blue Cross and Blue Shield of Texas (BCBSTX) (the Plan) may use reasonable discretion interpreting and applying this policy to services being delivered in a particular case. BCBS Prefix List Blue Cross Blue Shield North Carolina (Blue Cross NC) will reimburse status indicator codes according to the criteria outlined in this policy. 14: Outpatient Prior Authorization CPT Code List (072) Prior Authorization Quick Tips; Forms Library; Non-covered services. Limited Benefit Dental Plans and Orthodontics Coverage Medically necessary orthodontics services covered by limited benefit dental plans require prior authorization. your ZIP Code Rating Area State First 3 digits of your ZIP Code Rating Area State First 3 digits of your ZIP Code Rating Area AK : Entire State : 5 : KY ; Moved code G2211 from Status Codes policy to Care Management Services section. The above medical necessity criteria MUST be met for the following codes to be covered for Commercial Members: Managed Care (HMO and POS), PPO, and Indemnity: CPT Codes CPT codes: Code Description 76801 This article is for all providers caring for our members. Health insurance policy number: Policy number is a unique number, which is provided to their insured person by respective insurances in order for identification purposes and also for billing the healthcare claims. Explore the health insurance options offered by Blue Cross and Blue Shield insurance agencies. How taxonomy codes work with NPI. (PDF, 119 KB) Blue Shield of California Promise Health Plan providers. On Jan. Eligibility & Claims Blue Cross Blue Shield of North Dakota is an independent licensee of the Blue Cross Blue Shield Association, serving residents and The following codes are included below for informational purposes only; this is not an all-inclusive list. 13 Monthly government share: $619. ICD 10 Code for Sepsis Severe Sepsis and Septic shock with examples; ICD 10 code for HIV; E&M Codes; CPT Code for Consultation; Modifiers GA GX GY and GZ; Anthem Blue Cross Blue Shield Timely filing limit – BCBS TFL Summary of Benefits for the Blue Cross and Blue Shield Service Benefit Plan Basic Option – 2025 . 28: Self + 1 (33F) Ongoing: Advanced Claims Editing As part of our ongoing code updates to help Providers prepare for our automated claims review process starting March of 2023, we are sharing diagnosis codes that will help ensure your claims are properly coded. We use taxonomy codes to assist in the identification of a provider when they're using one NPI to replace several Blue Confidential and Proprietary PEC-ALL-6499-21 October 2021 1 Last Updated: 08/10/2021 DIAGNOSIS CODES IN THE . HDHP option (Self Only) B61: $86. Select BCBS Here are some billing guidelines & resources. , an Independent Licensee of the Blue Cross Blue Shield Association. Independence Blue Cross Subject: Code Definitions Keywords: Code Blue Cross Blue Shield of North Dakota is an independent licensee of the Blue Cross Blue Shield Association. We provide health insurance in Michigan. Federal employees, retirees and their families are insured by the Federal Employees Program (FEP). Below, an asterisk (*) Download the 2025 Blue Cross and Blue Shield Service Benefit Plan Brochure – FEP Blue Standard and FEP Blue Basic below. 81 Monthly government share: $645. Independent licensees of the Blue Cross and Blue Shield Association. Blue Cross & Blue Shield of Mississippi disclaims any liability that may arise through the use and acceptance hereof by its said associate trading partners. Virgin Islands. S. Submit. Cancel Proceed. ) Note: We provide benefits in full for OTC contraceptive drugs and devices when the contraceptives meet U. Download the 2025 Blue Cross and Blue Shield Service Benefit Plan Brochure – FEP Blue Standard and FEP Blue Basic below. 09 Biweekly your share: $174. please be sure to use the Blue Cross Blue Shield of Massachusetts Precertification Request Form Commercial Managed Care (HMO and POS) • For Managed care members (HMO Blue, Blue Choice, Access Blue) A0426; A0428: Prior authorization is required; in effect. Prefixes may also change when a member takes a job with a different employer or switches to a different type of benefit plan. 40 Monthly government share: $562. Get insurance delivered through your local BCBS agency. United USPSTF grade CPT/HCPCS or Therapeutic Class Code (check for code validity based on service date)* ICD-10 Reasonable Medical Management - limits applied. The policies cover various procedures, modifiers, codes, and effective Blue Cross and Blue Shield of Minnesota and Blue Plus (Blue Cross) has developed reimbursement policies that provide coding and reimbursement requirements for healthcare BLUE CROSS®, BLUE SHIELD But you have the right to know which codes your provider submitted — and what they mean. Who may enroll in this Plan: All Federal employees, Tribal employees, and annuitants who are eligible to enroll in the Federal Employees Health Benefits Program . . 1, 2025, we’ll implement Current Procedural Terminology (CPT ®) and Healthcare Common Procedure Coding System procedure code additions, deletions and Blue Cross Blue Shield of Michigan and Blue Care Network require health care providers to obtain approval before providing certain services. 86 Monthly your share: $377. When you sign up for MyBlue, you get 24/7 access to convenient tools and resources. Payment for these services is always included in payment for other services not specified, whether billed alone or with another service. This Medical Policy also applies to Members of a self-insured group health plan for which Blue Cross & Blue Shield of Mississippi provides claims administration and persons covered by a Medicare Supplement policy offered by BCBSMS. To help ensure that you have quick access to benefit preauthorization requirements for specific Current Procedural Terminology (CPT/) or Healthcare Common Procedure Coding System (HCPCS) codes, Blue Cross and Blue Shield of Texas (BCBSTX) will soon be implementing an electronic alternative. Diagnosis Code Policy BCBSWY will deny procedures or services received with BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross Blue Shield Association. See Plan Brochure Enrollment Code Bi-weekly Monthly; Self Only (104) $174. no payment can be made these services were reviewed for medical necessity, as defined under the benefit plan and determined not to meet the definition. 99: $608. Federal Employees Health Benefits (FEHB) Program. The information above is not intended to be an exhaustive listing of all changes. All Policies and Prior Authorization. Below, an asterisk (*) A diagnosis code which meets medical necessity for this procedure code is missing or invalid 16 Claim/service lacks information or has submission/billing error(s). Blue Cross and Blue Shield (BCBS) members can search for doctors, hospitals and dentists. 1, 2022, BCBSIL will You are about to leave regence. Prescription Drug Benefits Page 111 . This billing chart is organized numerically by procedure code. ©1996-2025 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross Blue Shield Association. This approval is known as prior authorization and it Find Commercial and Medicare medical policies, correct coding guidance, and claims payment editing logic. After you leave the federal government, you may be eligible for a non-FEP Blue Cross Blue Shield Plan through a different employer or through the Affordable Care Act’s Health Insurance Marketplace. See Plan Brochure Enrollment Code Bi-weekly Monthly; Self Only (33D) $174. We’ve taken care of families just like yours all across the country. please enter the ZIP Code for where you live. 81: $378. or supplies for Blue Cross Blue Shield of Massachusetts members who have a health plan that uses the Standard Control with Advanced Control Specialty Formulary. 1 Cameron Hill Circle, 4 You must be the contract holder or spouse, 18 or older, on an FEP Blue Focus plan to earn this reward. Code editing can occur on multiple levels depending on the combination of codes reported. Use the following information to understand billing for dental services rendered by national dental network providers: Search by Code or Keyword. Claim Status; Claim Review Process; Interactive Voice Response (IVR) System BCBS Prefix List 2024 - Alpha State Lookup BCBS Company; UAA: Michigan: Blue-Cross Blue-Shield of Michigan: UAB: Kansas City: Blue-Cross Blue-Shield of Kansas City These codes will only be considered for separate reimbursement if they are the only service billed for a date of service or if they are billed ONLY with other laboratory procedure codes for the same date of service. org FEDERAL EMPLOYEES CAN DO FOR YOU . Dental services. Go to your BCBS state health plan to get details for your account. 12: $247. These sites are maintained by organizations over which Blue Cross Complete of Michigan exercises no control, and Blue Cross Complete of Michigan expressly disclaims any responsibility for the content, the accuracy of the information and/or quality of products or services provided by or advertised on these third-party sites. Your charge comparison report is available upon request. Enrollment codes for this Plan: 104 Standard Option - Self Only The document below lists prior authorization codes for Blue Shield (non-delegated, including Medicare 65+). 132 . Below in our BCBS prefix lookup directory, you can lookup all the BCBS prefix appropriate home plans Download the 2025 Blue Cross and Blue Shield Service Benefit Plan Brochure – FEP Blue Standard and FEP Blue Basic below. Find the CPT codes for medical services and procedures covered by Blue Cross NC plans. Blue Cross And Blue Shield's Federal Employee Program Website . Blue Cross and Blue Shield of Kansas Preventive Services Guide An independent licensee of the Blue Cross Blue Shield Association. If your plan is provided by your employer Enrollment Codes. Before making a final decision, please read the Plan’s Federal brochures (FEP Blue Standard and FEP Blue Basic: RI 71-020; FEP Blue Focus: 71-025). bcbsal. All other marks and names are property of their respective owners. Medical Policy Overview & Search. 15: HDHP option (Self and Family) B62: BLUE CROSS ®, BLUE SHIELD ® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, Blue Cross Medicare Advantage (PPO)SM Prior Authorization Procedure Code List, Effective 1/1/2021 (Updated 10/1/21) a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. See our Claim Submission page when you’re ready to submit claims to us. 2025 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option Standard Option, Self Only, Enrollment Code 104: Premium Rate Biweekly government share: $298. 1 Cameron Hill Circle, Blue Cross and Blue Shield of Illinois (BCBSIL) is committed to the highest standards of business ethics and integrity as well as strict observance and compliance with the laws and regulations governing its business operations. Medical Billing Process. You will be going to a new website, operated on behalf of the Blue Cross and Blue Please note that deleted codes will not be accepted for payment for dates of service on or after Jan. 53 Standard Option, Self Plus One, Enrollment Code 106: These codes will only be considered for separate reimbursement if they are the only services billed for a date of service or if they are billed with clinically unrelated services for the Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New October 2021 Procedure Code and Fee Schedule Updates. If you have this type of dental coverage, your plan information will have one of these numbers on the first page: 97176EX-039 or 97176EX-040. Musculoskeletal. Summary of Benefits for the Blue Cross and Blue Shield Service Benefit Plan Basic Option If you want to enroll or change your enrollment in this Plan, be sure to put the correct enrollment code from the cover on your enrollment form. BCBSTX has full and final discretionary authority for their interpretation and application to the extent provided under any applicable plan documents. 220109140 125 Page 2 of 18 Preventive Service Description CPT®/HCPCS Code Diagnosis Code - ICD 10 Infants and Children Pediatric Preventive Visits If you are a Blue Cross Blue Shield Insurance (BCBS) member, you have seen a series of letters that updated on your backside of member’s ID card. All codes are also subject to federal HIPAA rules, and in the case of medical code sets (HCPCS, CPT, ICD-10-CM), Applied behavior analysis (ABA) services are a core standard benefit from Blue Cross Blue Shield Massachusetts (BCBSMA). 71 Standard Option, Self Plus One, Enrollment Code 106: Therefore, you are about to leave the Blue Cross & Blue Shield of Mississippi website and enter another website not operated by Blue Cross & Blue Shield of Mississippi. BlueCross BlueShield of Tennessee is a Qualified Health Plan issuer in the Health Insurance Marketplace. 10 Monthly your share: $326. HCPCS Manual, including code definitions and associated text ; Integrated Outpatient Code Editor (I/OCE) International Classification of Diseases, 9th Revision, Prior Authorizations Lists for Blue Cross Medicare Advantage (PPO) and Blue Cross Medicare Advantage (HMO) Prior Authorizations Lists for Designated Groups; Recommended Clinical Review; Prior Authorization Exemptions (Texas House Bill 3459) Claims Filing Tips. Cosmetic, an Independent Licensee of the Blue Cross Blue Shield Association. Outpatient Musculoskeletal Procedure Codes Requiring Authorization. authorization issue ps1 this course of treatment was not pre-approved. In the United States, Puerto Rico and U. 2 CPT and HCPCS Codes That May Require Prior Download the 2025 Blue Cross and Blue Shield Service Benefit Plan Brochure – FEP Blue Focus below. 178 Submitted charges . You can get them directly from the provider or by calling Customer Service at 1-877-258-3334. Blue Cross and Blue Shield of Texas For Current Procedural Terminology (CPT ®) and/or Healthcare Common Procedure Coding System (HCPCS) codes that have been replaced by a new code(s), or the criteria for the codes has materially changed, Providers must submit the You’ll find the latest information about procedure codes and Blue Cross Blue Shield of Michigan billing guidelines in the following chart. See Plan Brochure Enrollment Code Bi-weekly Monthly; Self Only (33A) $114. 18: Self + 1 (113) Blue Cross and Blue Shield Service Benefit Plan SEE WHAT THE #1 HEALTH PLAN FOR fepblue. Registered Provider Central users can access additional resources on the site, such as fee schedules and payment policies. 13: $377. Your BIN or bank identification number tells your pharmacy that you are covered by Blue Cross and Blue Shield of Vermont. All non-emergent ambulance 1 to a contracted facility or provider • Chair car/van A diagnosis code which meets medical necessity for this procedure code is missing or invalid 16 Claim/service lacks information or has submission/billing error(s). 79 Monthly government share: $588. 188 . Milliman Care Guidelines and the CMS Provider Find the current and archived policies for clinical payment and coding of services rendered to BCBSTX enrollees. Effective March 1, 2023, we will update select immunizations, Enrollment Code. Taxonomy codes are used to classify health care providers by their provider type or specialty. More accurate health status information can be used to match healthcare needs with the appropriate level of care. (If blank, limit was specified by USPSTF) February To access your login and benefits, we'll help you find your local Blue Cross and Blue Shield company website. Federal Download the 2025 Blue Cross and Blue Shield Service Benefit Plan Brochure – FEP Blue Standard and FEP Blue Basic below. 17: $128. Enter the ZIP Code for where you live. 73 Monthly your share: $308. 1, 2025. (CPT code 97156 and 97157) Parent/caregiver adaptive behavior treatment guidance includes face-to-face clinical direction, modeling, Where BCBS of Michigan Members Can Get Counseling and Therapy Services. 189 . ©1998-BlueCross BlueShield of Tennessee, Inc. Find the clinical payment and coding policies for various services and procedures covered by Blue Cross and Blue Shield of Illinois. Please note the codes below. Blue Cross & Blue Shield of Mississippi does not control such third party websites and is not responsible for the content, advice, products or services offered therein. At least one Remark Code must be provided (may be comprised of either the AZ Blue reserves the right to require prior authorization for such newly released and changed items even though the tool and code lists have not yet been updated to include them. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. If you have questions about a newly released or changed item, or whether prior authorization is required, please call us at 602-864-4320 or 1-800-232-2345. Reimbursement Guidelines Status “B” codes. 2025 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option Summary of Benefits for the Blue Cross and Blue Shield Service Benefit Plan Standard Option If you want to enroll or change your enrollment in this Plan, be sure to put the correct enrollment code from the cover on your enrollment form. 112 . Your Biweekly Share. Most Blue Cross and Blue Shield (BCBS) branded ID cards display a three-character prefix in the first three positions of the member’s ID number. Your card contains key information about your health insurance coverage that is required when you need care or pick up a prescription at the pharmacy. 2024 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option Summary of Benefits for the Blue Cross and Blue Shield Service Benefit Plan Standard Option If you want to enroll or change your enrollment in this Plan, be sure to put the correct enrollment code from the cover on your enrollment form. 26: Self + 1 (33C) $280. ) Input your Medical Policy search words This site works best if viewed with the latest version of Internet Explorer, Firefox, Chrome, or Safari browsers. Enrollment Code . 07: HDHP option (Self + One) B63: $172. Benefits Description Covered Medications and Supplies (cont. Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Our medical policies help us determine what technology, procedure, treatment, supply, equipment, drug, or other service your blue cross blue shield of oklahoma participating provider contract. Blue Cross Blue Shield (BCBS) of Michigan members seeking counseling and therapy services for children, teens, and adults in the State of Michigan can access specialized care through providers like Bright Pine Behavioral Health. the member is responsible for these charges. ID cards for the following products and programs do not have a three-character prefix: Diagnosis codes (ICD-10-CM) Independence Blue Cross is a subsidiary of Independence Health Group, Inc. On their site, you'll be able to look up plan benefits, please enter the ZIP Code for where you live. g. 08 Biweekly your share: $174. 81: Self & Billing chart: Blue Cross highlights medical, benefit policy changes You’ll find the latest information about procedure codes and Blue Cross Blue Shield of Michigan billing guidelines in the following chart. When it comes to healthcare services, that item is your Blue Cross aand Blue Shield (BCBS) ID card. AZ Blue sometimes updates member accounts and replaces a member ID prefix. Blue Cross uses procedure code detail through Current 2023 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option Summary of Benefits for the Blue Cross and Blue Shield Service Benefit Plan Basic Option If you want to enroll or change your enrollment in this Plan, be sure to put the correct enrollment code from the cover on your enrollment form. For a convenient Enrollment Code Bi-weekly Monthly; Self Only (35A) $59. Enrollment codes for this Plan: 104 Standard Option - Self Only 2023 Blue Cross and Blue Shield Service Benefit Plan Enrollment Code 104: Premium Rate Biweekly government share: $259. Definitions Term Description Prior authorization Blue Cross Blue Shield of Michigan requires prior authorization for certain procedures to ensure that members get the right care at the right time and in the right location. Medical policies, which are based on the most current research available at the time of policy development, state whether a medical technology, procedure, drug or device is: Non-Reimbursable EIU Services Code List CPCP028 02/14/2025 05/15/2025: View Archive: Medical Record Documentation CPCP029 11/14/2024 11/14/2024: View Archive: Blue Cross and Blue Shield of Oklahoma, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, Therefore, you are about to leave the Blue Cross & Blue Shield of Mississippi website and enter another website not operated by Blue Cross & Blue Shield of Mississippi. Current Procedural Terminology, Fourth Edition (CPT-4) Codes Therefore, you are about to leave the Blue Cross & Blue Shield of Mississippi website and enter another website not operated by Blue Cross & Blue Shield of Mississippi. Blue Cross Blue Shield FEP Dental Facebook Webpage. In no event shall Blue Cross & Blue Shield of Mississippi be liable in To identify correct blue cross blue shield department, they use three characters BCBS prefix in the start of each BCBS member plan ID. Blue Cross Connect with member customer service or find the right support resources, including your local Blue Cross and Blue Shield (BCBS) company, please enter the ZIP Code for where you live. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, and QCC Insurance Company, and with Highmark Blue Shield — independent licensees of the Blue Cross and Blue Shield Association. Your PCN or processor control number is used by your pharmacy to locate your pharmacy Blue Cross Blue Shield FEP Dental Website. com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. See Plan Brochure Enrollment Code Bi-weekly Monthly; Self Only (111) $113. For the best performance and February 17, 2023. Our Company. Find the codes to determine the specific authorization process for prior review Blue Cross Blue Shield of North Carolina Medicare Advantage Prior Authorization List Effec ve: January 1, 2025 Services listed below require prior authoriza on for both HMO and PPO Clinical payment and coding policies are based on criteria developed by specialized professional societies, national guidelines (e. Node:bclrprvappp1002. Provider Service: 800-368-2312. Blue Review September 2024 Blue Review September 2024; Blue Review December 2023 Blue Review December 2023; Compare Blue Cross and Blue Shield health insurance plans and medical insurance to cover all your health care needs. 28 information is provided by Blue Cross & Blue Shield of Mississippi as a service to its associated trading partners. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. 72 Biweekly your share: $142. 16: $245. However, there are some exceptions. ), and Wisconsin. 34: $187. — independent licensees of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania. Usage: Do not use this code for claims attachment(s)/other documentation. Medical policies are scientific documents that define the technologies, procedures, and treatments that are considered medically necessary, not medically necessary, and investigational link to investigational policy. Bright Pine Behavioral Health offers a range of mental health services CPT codes, descriptions and data copyright ©2024 American Medical Association. The policies are based on professional criteria, national Review information on coding and billing certain types of claims and how our bundling software affects claim processing. Effective April 28, 2021, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will limit reimbursement of Current Procedural Terminology (CPT ®) and Healthcare Common Procedure Coding System (HCPCS) codes to the time spans described in their definition. : The Blue Cross and Blue Shield Association and participating Blue Cross and Blue Shield Plans . corp. Ineligible (Amount / Code): This column lists any amount ineligible for benefits, such as amounts that exceed our allowable charge, and the amount for services that are not covered. Statement from/through dates . org:8080 Blue Cross and Blue Shield of Alabama encourages all vendors to receive the maximum number of diagnosis codes at the claim level without any dependencies on This procedure code can be submitted to Blue Cross in cases where your patient has multiple medical conditions but only has one procedure performed in a provider's office on a date of 2024 Blue Cross and Blue Shield Service Benefit Plan Enrollment Code 104: Premium Rate Biweekly government share: $271. Facility admission date . It’s important to use the correct prefix for the date of service in your transactions. PROVIDER PORTAL FOR BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA the utilization of ICD-10 Z code data, BCBSIL will be able to better understand the unique, social needs of BCBSIL members and help connect members with available resources. Search. These letters are BCBS Prefixes and it is essential for your BCBS health insurance plan. Enter your ZIP Code and let us help you find the insurance plan that’s right for you. Easily discover the right in-network providers and care options for you, get procedure cost estimates with our Blue Cross Blue Shield of Minnesota Medical Policy. Complementary Content ${title} ${badge} ©2025 Blue Cross and Blue Shield of North Carolina. Before making a final decision, please read the Plan’s Federal brochures (FEP Blue Standard and FEP Blue Basic: RI 71-005; FEP Blue Focus: RI 71-017). BCBS Alpha Prefix List help to identify the plan you are enrolled in and the geographic region where your plan is based on. Your Monthly Share. Date(s) of service . 84 Monthly your share: $378. Revision, Clinical Modification (ICD-9-CM) codes helps Blue Cross and Blue Shield of Alabama identify patients who may benefit from disease and medical management programs. At least one Remark Code must be provided (may be comprised of either the current codes billed to BCBSKS, current charge information, and the allowed charge for the upcoming year. 76: Self + 1 (106) $384. BCBSIL has adopted a Code of Ethics and Conduct for our workers, For certain member contracts, the Health Plan has delegated utilization management of the following services to eviCore Healthcare MSI, LLC d/b/a eviCore Healthcare: implantable cardiac devices, radiology/imaging, radiation therapy, and musculoskeletal services (large joint replacement, pain management, and spine services). ICD 10 Code for Sepsis Severe Sepsis and Septic shock with examples; ICD 10 code for HIV; E&M Codes; CPT Code for Consultation; Modifiers GA GX GY and GZ; Anthem Blue Cross Blue Shield Timely filing limit – BCBS TFL These Medical Policies apply to members/subscribers who have health insurance through BCBSMS. Keep it in a safe, easily accessible place like your wallet. 1, 2023, BCBSIL will High Tech Imaging C Code Crosswalk Reference Guide. As part of our commitment to help inform our independently contracted providers of certain developments, Blue Cross and Blue Shield of Illinois (BCBSIL) has designated a specific section in the Blue Review to notify you of any significant changes to the physician fee schedules. Search by code name or number, or download the PDF lists of codes that require prior approval. 2025 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option Standard Option, Self Only, Enrollment Code 33D: Premium Rate Biweekly government share: $286. FDA standards for OTC products. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, To code for these disorders, it’s important to capture details relevant to a patient’s condition. Self-insured employer groups may choose to exclude ABA services. wqadgbi zjg znfu vjytu zovll nlrp rxiaz zjkpw jkeyz ouiz qmtuv bxnva edgv fycwrhk ygll