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This newsletter includes short summaries, reminders and updates for Blue Cross and BCN providers. Please visit The Record or BCN Provider News for complete newsletter editions.
Clinical editing appeal submission reminders To help expedite your clinical editing appeal response, we've put together some helpful tips. Read more: Clinical editing billing tips in the January–February 2021 BCN Provider News Additional information can be found in the Appealing a BCN clinical editing denial PDF: Here's how to find the document:
Blue Cross follows CMS guidelines for use of JW modifier Blue Cross follows the Centers for Medicare & Medicaid Services’ standard billing guidelines for the use of the JW modifier to identify unused drugs or biologicals from single-use vials or single-use packages that are appropriately discarded. This applies to professional claims only. Read more: June 2022 issue of The Record We invite you to join PGIP We’re pleased to announce that we’ll accept applications for the Physician Group Incentive Program from new physician organizations from July 1-31. To request application materials, send an email to valuepartnerships@bcbsm.com. Reimbursement for Avastin eye injections changing For claims received on or after Aug. 1, reimbursement will change to $160 per eye injected with compounded Avastin® (bevacizumab) eye injections for Medicare Plus Blue℠ and BCN Advantage℠ members. Read more: June 2022 issue of The Record Landmark Health program expanding Blue Cross and Blue Care Network have been working with Landmark Health to make high-intensity in-home care available to Medicare Advantage members with multiple chronic conditions. Beginning July 1, we’re expanding the program to include additional members in Southeast Michigan counties, as well as the Lansing and Flint areas. Read more: June 2022 issue of The Record Appropriate use of modifier 59 As a reminder, you must follow the guidelines communicated in the September 2021 Record article when appending modifier 59 on Medicare Plus Blue claims. We have begun editing claim lines when modifier 59 is appended to ensure the correct coding of services. Read more: June 2022 issue of The Record
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Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. |