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Commercial Reimbursement Policy Updates for January 1, 2024
Reimbursement PolicyRevisions
Bundling Guidelines

Added Medical Nutrition Therapy language to Dialysis Routine Supplies and Equipment.  Medical Nutrition Therapy provider specialty language added in Reimbursement Guidelines.  Medical Director approved.  Effective 1/1/2024.

Evaluation and Management Services

Revenue Code policy reference added to Treatment Rooms section.  No change to policy intent.  Effective 1/1/2024.

Place of Service

Added Hyperbaric Oxygen Therapy to Reimbursement Guidelines.  Medical Director approved.  Effective date 1/1/2024.

Modifier GuidelinesRemoved criteria for “Power wheelchair(s) are not eligible for reimbursement when billed with modifier NU (new equipment) or modifier UE (used equipment)”. Effective date 1/1/2024.

Radiation Therapy Services

Routine policy review. Code 77301 and proton beam therapy clarified. Medical Director approved. Effective 1/1/2024.

Supply and Equipment ReimbursementLanguage clarification regarding Gradient Compression Garments. Nighttime Gradient Compression Garments added. “Adult” added to clarify lifetime of Orthotics and Prosthetics. Coding section updated with new compression codes. No change to policy intent.  Effective 1/1/2024.
TelehealthAdded procedure code G9887.  Effective 1/1/2024.

Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.

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