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

May 2019

Clinical Payment and Coding Policy Updates

Blue Cross and Blue Shield of Texas (BCBSTX) has implemented clinical payment and coding policies based on criteria developed by specialized professional societies and national guidelines (e.g., MCGTM), the Centers for Medicare & Medicaid Services (CMS) Provider Reimbursement manual and others (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 have been updated:

The following policies will be added:

Refer to the Clinical Payment and Coding Policies section on the BCBSTX provider website for more information.

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