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Practice Management Alert

Payer Updates:

BCBS Settlement Provisions Are Now in Effect

Published on Thu Feb 19, 2009

Get to know the settlement details. If you bill to Blue Cross Blue Shield, take note. The provisions of a settlement agreement between physicians and the Blue Cross Blue Shield Association that require the settling BCBS companies to follow most CPT rules went into effect on January 21, 2009. The provisions now effective include: - Payment of add-on codes without reduction for multiple procedure logic - Separate recognition and payment of E/M codes appended with modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) when billed with a service procedure or surgical code - Separate recognition and payment for supervision and interpretation and radiologic guidance codes - Payment for codes submitted with modifier 59 (Distinct procedural service) to the extent they follow CPT rules regarding designation of separate procedures - Prohibition on global periods for surgical [...]
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