The Record

The Record header image

Subscribe | The Record Archive | Contacts | bcbsm.com

September 2021
Image of professional

September is Suicide Prevention Awareness Month
More than 47,500 people in the U.S. die by suicide each year, according to the Centers for Disease Control and Prevention. Read more.

Inside this issue for you

See all the articles in this issue, grouped by category, below.

Professional

New method of obtaining emergency crisis assessment for psychiatric issues, treatment coming
CareCentrix to manage network for independent home infusion therapy and ambulatory infusion suite providers, starting Jan. 1
Learn more about submitting authorizations for our new Medicare Advantage home health care program
CareCentrix monitoring home health authorizations for missing HIPPS codes for Medicare Plus Blue members
We’ve updated our Choices for Care and Blue Cross Online Visits toolkits
Quarterly update: Requirements changed for some commercial medical benefit drugs
We’re transitioning to new pharmacy benefit manager
We’re changing how we pay for certain drugs that should be administered by health care provider
Additional drugs to require prior authorization for URMBT members with Blue Cross non‑Medicare plan
Clarification: Services requiring AIM prior authorization
Policy update coming for nonchemotherapy drug administration coding
Claim editing update coming later this year to Medicare Plus Blue actinotherapy and photochemotherapy claims
HMS launches new provider portal for audits
Claim editing update for modifier 59 coming later this year to Medicare Plus Blue claims
Claim editing enhancements coming to Blue Cross commercial claims
Asparlas will require prior authorization for URMBT members with a Blue Cross non‑Medicare plan
Cosela and Libtayo to require prior authorization for URMBT members with a Blue Cross non‑Medicare plan
Rybrevant requires prior authorization for most members
Data shows higher flu vaccine rate leads to lower illnesses, hospitalizations and deaths
Lunch and learn webinars for physicians and coders focus on risk adjustment, coding
Reminder: e‑learning lesson on E/M guidelines available on provider training website
Reminder: On‑demand training available
Reminder: New e‑learning training videos focus on Medicare Star Ratings
Clarification: Pending authorization requests

All Providers

September is Suicide Prevention Awareness Month
Our care management program offers support for patients, health care providers
No‑cost COVID‑19 treatment ending Sept. 30
Reminder: Participating providers may only bill members for applicable deductibles and copayments
Blue Cross retires modifier 22 payment policy for pain control optimization pathway program
Fiscal year 2022 ICD‑10‑CM and PCS code updates now available
Billing chart: Blue Cross highlights medical, benefit policy changes

Pharmacy

We’re changing how we pay for certain drugs that should be administered by health care provider
Additional drugs to require prior authorization for URMBT members with Blue Cross non‑Medicare plan
Asparlas will require prior authorization for URMBT members with a Blue Cross non‑Medicare plan
Cosela and Libtayo to require prior authorization for URMBT members with a Blue Cross non‑Medicare plan
Rybrevant requires prior authorization for most members

Facility

New method of obtaining emergency crisis assessment for psychiatric issues, treatment coming
CareCentrix to manage network for independent home infusion therapy and ambulatory infusion suite providers, starting Jan. 1
Learn more about submitting authorizations for our new Medicare Advantage home health care program
CareCentrix monitoring home health authorizations for missing HIPPS codes for Medicare Plus Blue members
Additional drugs to require prior authorization for URMBT members with Blue Cross non‑Medicare plan
Clarification: Services requiring AIM prior authorization
Claim editing update coming later this year to Medicare Plus Blue actinotherapy and photochemotherapy claims
Facility charges for daily respiratory therapy services will be prorated
HMS launches new provider portal for audits
Asparlas will require prior authorization for URMBT members with a Blue Cross non‑Medicare plan
Cosela and Libtayo to require prior authorization for URMBT members with a Blue Cross non‑Medicare plan
Rybrevant requires prior authorization for most members
Lunch and learn webinars for physicians and coders focus on risk adjustment, coding
Reminder: On‑demand training available
Clarification: Pending authorization requests

For BCN news and information, see the current issue of BCN Provider News.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

We respect your right to privacy - view our policy.