Description
Blue Cross NC utilizes the guiding principles outlined below for outpatient facility claims editing. These principles may help practitioners anticipate and understand the likely outcome of claims submissions. Blue Cross NC follows coding edits that are based on industry sources, including, but not limited to; CPT® guidelines from the American Medical Association, specialty society organizations, and CMS including NCCI, OCE, and MUE.
Blue Cross NC follows the instruction and guidance of code and claim form issuers, including but not limited to CPT, HCPCS, UB-04, and ICD-10.