07/21/2025
BCBSM/BCN
Publications
July 2025 Issue Available HERE.
A Few Articles You Will Want to Check Out:
- Pharmacy news roundup
- Yesintek to have a site-of-care requirement for most commercial members, starting Sept. 1
- New, updated requirements for some medical benefit drugs for Blue Cross commercial URMBT members start Aug. 20
- Resources for providers, patients to manage chronic conditions, hospital services, follow-up care
- Recorded webinar for providers, office staff focuses on prior authorization best practices
- Webinars for physicians, coders focus on documentation, coding
- Wednesday, August 20: Coding modifiers and SDOH
- Wednesday, October 8: ICD-10 Updates for 2026
- Wednesday, November 19: Oncology
- Wednesday, December 17: CPT Updates for 2026
- Billing chart: Blue Cross highlights medical, benefit policy changes
- 2025 CPT Category III update: New, deleted codes
July/August Bi-Monthly Issue Available HERE.
A Few Articles You Will Want to Check Out:
- Select Medicare Advantage members will receive Cologuard test kits in July (Page 10)
- Medical policy updates (Page 14)
- Behavioral health providers shouldn’t submit claims for behavioral health collaborative care services (Page 18)
- Pharmacy news roundup (Page 21)
- Bill HCPCS code J3490 for Depo-Provera for commercial members (Page 22)
- HelpScript enrollment service for manufacturer copay assistance will start July 1 for select medical benefit drugs for some BCN commercial members (Page 22)
- We’re changing how we cover Revlimid, starting August 1 (Page 24)
- Fees for new telemedicine E/M procedure codes to start July 1 (Page 25)
- 2025 billing changes affect provider-delivered care management services (Page 27)
- Claims status inquiry process (Page 28)
- Reminder: Follow correct billing guidelines when submitting claims for secondary payment (Page 31)
- Coding corner: Acute conditions not typically managed in office setting (Page 32)
- Clinical editing updates (Page 33)
- Medicare Advantage members can request a non-emergency transfer from one acute care facility to another at any time (Page 35)
- Preview questionnaires and medical necessity criteria (Page 39)