Clinical Payment and Coding Policy Updates
AI Summary
Blue Cross Blue Shield of Texas updated five clinical payment and coding policies affecting surgical procedures, modifier usage, and infusion services. The changes include updates to increased procedural services (Modifier 22), global surgical packages, co-surgeon/team surgeon policies, multiple surgical procedures, and infusion services with staggered effective dates from April 15 to July 18, 2025.
Action Required
By April 15, 2025: Billing team must review and implement updated policies for CPCP013 (Modifier 22 usage) and CPCP014 (Global Surgical Package). By April 18, 2025: Update co-surgeon/team surgeon billing procedures per CPCP009. By April 23, 2025: Revise multiple surgical procedure billing practices per CPCP015. By July 18, 2025: Update infusion services billing per CPCP019. Access full policy details at bcbstx.com provider portal and update billing software rules, encounter forms, and staff training materials accordingly.
Plan Types
All Plans
States
TX
Specialties
general-surgery, ortho, cardiothoracic-surgery, neurosurgery, plastic-surgery, vascular-surgery, ophthalmology, ent, urology, ob-gyn, anesthesiology