Clinical Payment and Coding Policy Updates from Annual Reviews

January 14, 2022

Blue Cross and Blue Shield of Texas has completed the annual review of the Clinical Payment and Coding Policies (CPCP) shown below. Minor updates were added and the revised policies are effective January 14, 2022 and posted to the provider website.

Chiropractic Services PDF Document

Inpatient/Outpatient Unbundling Policy PDF Document

Neonatal Intensive Care Unit (NICU) Level of Care Authorization and Reimbursement PDF Document

Wasted/Discarded Drugs and Biologicals Policy PDF Document

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.

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.