06/04/2019

BCBSM/BCN

Publications

June 2019 – Issue

• New care management program to launch in 2020
• SCIO Health Analytics auditing outpatient claims for commercial business
• HCPCS update: New codes added
• Billing chart: Blues highlight medical, benefit policy changes
  • New Payable Procedures Include: J9999 - Libtayo (cemiplimab-rwlc), J3590 - JIVI (antihemophilic factor [recombinant] Pegylated-aucl), J9171 - Docefrez (docetaxel), J9271 - Keytruda (pembrolizumab)
• You must use network laboratories for your Blue Cross and BCN patients
• Medicare Part B medical specialty drug prior authorization list changing
• Here’s helpful information about clinical editing appeals for Blue Cross PPO and Medicare Plus Blue claims

CHECK OUT THESE ARTICLES AND MUCH MORE HERE!

A Few Articles You Won’t Want to Miss:

• Here’s how to confirm the networks you participate in
• Medical record guidelines policies require providers to maintain member records
• Inflectra to be the preferred infliximab product for adult BCN Commercial members
• AIM Specialty Health to manage medical oncology medications for BCN starting August 1
• We’ve made additional changes to the peer-to-peer review process

And Much More…MAY/JUNE Bi-Monthly Issue Available HERE