BCBSM Medicare Advantage PPO will update its physician office lab list

Blue Cross Blue Shield of Michigan will update its Medicare Advantage PPO Physician Office Lab List on or after Oct. 29, 2014, to more accurately reflect currently recognized codes and procedures.

The list is housed on the Medicare Advantage section of BCBSM’s provider website at bcbsm.com/provider/ma. To find the list:

• Click on Medicare Plus Blue.
• Click on Provider Toolkit.
• Under “Coverage Details,” clickon Medicare Advantage PPO lab network.
• You can find the list near the bottom of the page.

Keep the following in mind:

• Providers who render lab services that aren’t on this list will not be paid.
• BCBSM Medicare Advantage PPO members cannot be billed for a lab service that isn’t on this list.
• Providers must have the appropriate complexity level of certification required to perform and bill applicable procedures.

Among the key changes are:

• Seventeen procedure codes will be deleted.
• Forty procedure codes will be added.
• Some of the new codes added will include select provider-performed microscopy procedures and two blood count codes.

In the meantime, you can continue to use the current Medicare Advantage Physician Office Lab List. If you have any questions, please contact your provider consultant.