Notification of Reimbursement Policy Revisions Effective November 30, 2021 (Posted October 1, 2021)
|Bundling Guidelines "Notification"||
Added statement to Balloon Sinuplasty section "Modifiers 58, 59, 78 and 79 (or XE, XS, XP, XU) will not allow additional payment when appended to these codes." Policy notification given 10/1/2021 for effective date 11/30/2021.
|Nonpayment for Serious Adverse Events "Notification"||
Clarifying statements added to Reimbursement Guidelines section "All providers, including, but not limited to inpatient psychiatric hospitals, critical access hospitals, or other facilities granted CMS exemption status, are subject to POA, HAC, and Never Event editing." and "Blue Cross Blue Shield North Carolina (Blue Cross NC) will not reimburse claim lines containing diagnoses or procedures with "N" or "U" POA indicators. The presence of "N" or "U" indicate a condition was hospital acquired and therefore not eligible for reimbursement." POA indicators added to Billing and Coding section. Notification given 10/1/2021 for effective date 11/30/2021.
|Radiation Therapy Services "Notification"||
Policy renamed from "Intensity Modulated Radiation Therapy" to "Radiation Therapy Services". Policy expanded from IMRT to include SRT. Notification on 10/1/2021 for effective date 11/30/2021.