Clinical Payment and Coding Policy Update – 12/14/2020

Blue Cross and Blue Shield of TX has revised the following Clinical Payment and Coding Policy effective March 18, 2021 and has been posted to the provider website:

Inpatient/Outpatient Unbundling Policy – Facility 

Be sure to check eligibility and benefits before rendering service(s) to make sure a procedure is a covered benefit for the member and determine any prior authorization requirements. Refer to Clinical Payment and Coding Policies under Standards and Requirements on the provider website to review the current CPCPs.

If you have any questions or if you need additional information, please contact your BCBSTX Network Management Representative.

Clinical payment and coding policies are based on using healthcare professionals and industry standard guidelines. The clinical payment and coding guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers