Coding Related Updates
BCBSIL adheres to the nationally recognized coding guidelines as defined by the Current Procedural Terminology (CPT®) Codebook. Accurate coding enables BCBSIL to determine the benefit level that is warranted in accordance with the member’s benefit certificate.
This section is to be used as a supplementary guide when coding for services rendered. We routinely review the documentation in this section for relevancy and accuracy. Updates are made annually for Health Care Service Corporation (HCSC) Adverse Denial Rates. Other sections are updated as needed throughout the year.
Coding Related Updates
- ClaimsXtenTM Rule Descriptions (May 2013)
- Procedures with Associated Medical Policies (May 2013)
- Preventive Colonoscopy Claims FAQs (November 2012)
- National Drug Code (NDC) Billing Guidelines (September 2011)
- HCSC Adverse Denial Rate Calendar Year 2010 (January 2011)
- Bilateral Surgery Pricing (August 2010)
- Update: Not Otherwise Classified J-Codes (Revised September 2009)
- Serious Vs. Non-Serious Mental Illness (December 2008)
- Billing Dispute External Review Process (BDERP) (December 2008)
- CLIA Waived Laboratory Tests (December 2008)
- Guidelines for Billing Unlisted J Codes (October 2008)
Other available references:
The “Fairness in Contracting” column in the monthly Blue Review provider newsletter is designed to notify you of any changes to the physician fee schedules. This newsletter is available by mail, email or online. View current or past issues of the Blue Review.
For additional information and one set of guidelines regarding health care benefit coverage determinations, refer to the BCBSIL Medical Policies.
CPT copyright 2010 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the AMA.
