Blue Review
A newsletter for physician, professional, facility, ancillary and Medicaid providers

August 2018

Updates to Clinical Payment and Coding Policies

Blue Cross and Blue Shield of Texas (BCBSTX) has implemented clinical payment and coding policies based on criteria developed by specialized professional societies, national guidelines (e.g., MCG) and the Centers for Medicare & Medicaid Services Provider Reimbursement manual. Additional sources are used and can be provided upon request.

The clinical payment and coding guidelines are not intended to provide billing or coding advice, but to serve as a reference for facilities and providers. The following policies are being implemented or have been updated:

Refer to Clinical Payment and Coding Policies under Standards and Requirements on the BCBSTX provider website for details on the policies being implemented or updated.

If you have any questions or if you need additional information, please contact your BCBSTX Network Management Representative.