Clinical Payment and Coding Policies — Corrected Claim Submission & Inpatient/Outpatient Unbundling Policy

Oct. 15, 2019

Blue Cross and Blue Shield of Texas (BCBSTX) has updated the Clinical Payment and Coding Policies page to include the following policy additions or changes:

  • Corrected Claim Submission: Added effective Jan. 15, 2020
  • Inpatient/Outpatient Unbundling Policy: Changes - Effective Oct. 15, 2019

Clinical Payment and Coding Policies are based on criteria developed by specialized professional societies, national guidelines (e.g., MCGTM) 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.

Refer to Clinical Payment and Coding Policies under Standards and Requirements on the provider website to review the updates.

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


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