Evaluation and Management of Emergency Department Coding – Clinical Payment and Coding Policy Posted

April 24, 2017

Blue Cross and Blue Shield of Texas (BCBSTX) is implementing clinical payment and coding policies based on criteria developed by specialized professional societies, national guidelines (e.g. Milliman Care Guidelines (MCG)) and the 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 policy is being implemented effective 07/24/2017:

Refer to Clinical Payment and Coding Policies under Standards and Requirements on the for details on the policies being implemented and additional information on when they apply.

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