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Payment policy
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Updates
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Acupuncture
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- Annual coding update; revised descriptions of 97811 and 97814
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Chiropractic
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- Annual coding update; revised descriptions of 97811 and 97814
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COVID-19 temporary payment policy
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- Annual coding update; removed 2023 deleted COVID vaccine and admin codes
- Removed deleted codes G2023, U0003-5
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CPT and HCPCS Modifiers
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- Annual coding update
- Modifier SA implementation delay update
- Deleted modifiers JG and MB-MH
- Revised description of modifier TB
- Updated link for modifier 59 code pair
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Evaluation and Management
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- Annual review
- Added remote physiological monitoring to reimbursed services
- Expanded time criteria
- Annual coding update
- Added G0556-8 as not reimbursed
- Added G0545 as reimbursed for Medicare Advantage only
- Added 96041 as not reimbursed
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Expanded Molecular Panel Testing of Cancers
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- Annual coding update; added new codes 0523U and 0530U
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Family Planning
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- Annual coding update
- Added 96041
- Deleted 96040
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Frequency
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- Annual coding update
- Revised descriptions of 97811, 97814, and 98966-98968
- Marked deleted codes 99441-99443 and G2012
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General Coding and Billing
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- Annual coding update
- Expanded range of Category III CPT codes
- Updated codes of multianalyte assays with algorithmic analyses
- Updated M measurement HCPCS codes
- Updated link for modifier 59 code pairs
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Inpatient Acute Medical Admission
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- Updated to align with member benefit change effective January 1, 2025: we will not reimburse inpatient services once a Blue Cross member loses coverage during an inpatient stay
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Interim Billing – Facility
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Laboratory and Pathology
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- Annual review; updated template
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Medicare Advantage Inpatient Acute Care – Facility
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- Annual review; updated template
- Updated readmission policy for discharge dates on or after January 1, 2025
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Mental Health and Substance Use
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- Annual coding update
- Added G0532-G0536 as reimbursed for Medicare Advantage only
- Added G0546-51 as reimbursed
- Revised descriptions of G2069, G2076-7
- Deleted G2070-G2072
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Non-Reimbursable Services
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- Annual coding update
- Updated professional and facility provider lists with new, revised, and deleted codes for 2025
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Outpatient Clinic Services – Facility
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- Annual review; updated template
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PT/OT- Independent Practice
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- Annual coding update
- Revised descriptions of 98975-98977
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Radiology – Multiple Imaging
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- Annual coding review
- Added existing codes 0640T, 0807T, 0808T, 0876T, and 0898T
- Added new codes 74363, 76016-76019, 0944T, 0946T and 0947T
- Deleted modifiers MB-MH and HCPCS codes G1001-G1024
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Surgery-Professional
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- Annual coding update
- Expanded skin substitute Q code range
- Added G0559 as reimbursed for Medicare Advantage only
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Telehealth (Telemedicine) – Medical Services
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- Annual coding review
- Removed 99441-43 and G2012
- Revised code descriptions for 98966-68 and 98970-72
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Telehealth (Telemedicine) – Mental Health
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- Annual coding review
- Removed 99441-43 and G2012
- Revised code descriptions for 98966-68 and 98970-72
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Third Party Services
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Urgent Care Center
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- Annual coding update
- Removed modifier SA reduction information
- Removed not reimbursed codes 99421-3 and 99446-52
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Vision Services
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- Annual coding update
- Revised 92133 and added 92137
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