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September 2022
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Update: Crisis services provide support for members with urgent behavioral health concerns
Since we last wrote about our crisis services, a new facility joined our program: Pine Rest, located in Grand Rapids. Read more.

Inside this issue for you

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

Professional

More Medicare Advantage members to become eligible for Landmark Health’s in-home care program
Medicare Advantage members with open gaps in care to receive in-home test kits
New lab program for Blue Cross commercial and Medicare Plus Blue now live
Some SecureCare clinical performance reports to be available later than expected
We’ve made some questionnaire changes in e-referral system
Additional drugs to have requirements for URMBT members with Blue Cross non-Medicare plans
Payment policy for radiofrequency and laser treatment of varicose veins aligns with medical policy
Training opportunities available to learn more about pharmacogenomics
We’ve updated our e-learning videos on Medicare Star Ratings for 2022
Lunch and learn webinars focus on risk adjustment, coding
New on-demand training available
Byooviz to be preferred ranibizumab drug for Medicare Advantage members, starting Oct. 4
Here’s what you need to know about billing and requesting prior authorization for denosumab
3 additional medications require prior authorization for Medicare Advantage members
Importance of statin therapy for patients with cardiovascular disease, diabetes
Remind your eligible patients to get regular mammograms
Here are some resources to help patients manage chronic conditions
Reminder: Only certain modifiers payable for services provided in OPC facilities for Blue Cross commercial members
Reminder: Private duty nursing services will require prior authorization
Blue Cross AIC and HIT professional providers may see new rejection code when medical drug claims are incorrectly billed
Radiology code *71271 no longer requires prior authorization for Blue Cross commercial members

All Providers

Update: Crisis services provide support for members with urgent behavioral health concerns
Announcing next phase of Provider Secured Services and web-DENIS retirement
We’ve enhanced Benefit Explainer to include new payability limitation
Fiscal year 2023 ICD-10-CM and PCS code updates now available
2023 early release CPT vaccine code added
Billing chart: Blue Cross highlights medical, benefit policy changes

Pharmacy

Additional drugs to have requirements for URMBT members with Blue Cross non-Medicare plans
Training opportunities available to learn more about pharmacogenomics
Byooviz to be preferred ranibizumab drug for Medicare Advantage members, starting Oct. 4
Here’s what you need to know about billing and requesting prior authorization for denosumab
3 additional medications require prior authorization for Medicare Advantage members

Facility

Submit requests for commercial inpatient rehabilitation admissions and extensions only through e-referral
Use updated forms for post-acute care prior authorization requests for commercial members
New lab program for Blue Cross commercial and Medicare Plus Blue now live
Some SecureCare clinical performance reports to be available later than expected
Additional drugs to have requirements for URMBT members with Blue Cross non-Medicare plans
Payment policy for radiofrequency and laser treatment of varicose veins aligns with medical policy
Lunch and learn webinars focus on risk adjustment, coding
Byooviz to be preferred ranibizumab drug for Medicare Advantage members, starting Oct. 4
Here’s what you need to know about billing and requesting prior authorization for denosumab
3 additional medications require prior authorization for Medicare Advantage members
Reminder: Only certain modifiers payable for services provided in OPC facilities for Blue Cross commercial members
Reminder: Private duty nursing services will require prior authorization
Radiology code *71271 no longer requires prior authorization for Blue Cross commercial members

National Suicide Prevention Awareness Month

September is National Suicide Prevention Awareness Month, a time to raise awareness of how we can work together to help those at risk of suicide. As you read in an article in the August Record, 988 has been designated as the new three-digit dialing code that will route callers to the National Suicide Prevention Lifeline. Also, Blue Cross Blue Shield of Michigan has expanded its crisis services program. Read more by clicking here.

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

For news and information about our strategic goals and initiatives, see the current issue of Hospital and Physician Update.

To subscribe to any of our newsletters for health care providers, click here.

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