March 28, 2019
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. Milliman Care Guidelines (MCG)) and the Centers for Medicare & Medicaid Services (CMS) 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 effective June 28, 2018:
- Co-Surgeon/Team Surgeon Modifiers
- Hernia Repair
- Increased Procedural Services (Modifier 22)
- Global Surgical Package
The following policy has been updated and changes will be effective June 28, 2018:
Refer to Clinical Payment and Coding Policies under Standards and Requirements on the provider website for the Clinical Payment and Coding Policies available.
If you have any questions or if you need additional information, please contact your BCBSTX Network Management Representative.