Clinical Payment and Coding Policy Updates
AI Summary
Blue Cross Blue Shield Texas updated multiple clinical payment and coding policies including retirement of surgical services policy TXCPCP03, updates to chiropractic services, outpatient services prior to readmission, physical medicine, and preventive services policies. New non-reimbursable experimental services list was also posted.
Action Required
By June 30, 2025: Billing team must stop using retired policy TXCPCP03 for surgical and non-surgical services billing. Review and implement updated policies for chiropractic services (CPCP016), outpatient services prior to readmission (CPCP038), overlapping facility services (CPCP039) effective June 20, 2025. Before July 1, 2025: Update preventive services billing per CPCP006. Before September 22, 2025: Prepare for physical medicine policy changes (CPCP040). Review non-reimbursable experimental services list (CPCP028) to avoid claim denials.
Plan Types
All Plans
States
TX
Specialties
all-specialties