Documentation and Coding Training Series

CRITICAL DEADLINES - Multiple Actions Required: 1. By 2026-10-01: Billing team must sign up for Electronic Fund Transfer (EFT) to receive payments. Paper checks will no longer be issued. Access EFT enrollment through Blue Cross VT provider portal or contact provider relations at (888) 449-0443, option 1. Failure to enroll will result in non-receipt of payments. 2. By 2026-09-01: Billing team must review and implement Documentation and Coding Training Series videos. Watch all training modules to ensure coders, billers, and providers understand updated best practices. Assign training completion to all relevant staff. 3. By 2026-10-30: Billing team must audit all current claim submissions for NDC (National Drug Code), Unit of Measure, and Quantity compliance. Review billing software to ensure NDC billing rules are correctly configured. Beginning 2026-10-30, non-compliant claims will be systematically denied. Update billing templates and claim submission processes immediately. 4. For dates of service on or after 2026-09-01: Billing team and providers must transition maternity billing from global obstetric codes to new maternity services codes. Specifically: - First prenatal visit: Bill E/M code with modifier -TH + ICD-10 Z34A code (with required 4th character for gestation) - Subsequent antepartum visits: Bill E/M code with modifier -TH (must support MDM or time per CPT guidelines) - Update EMR templates and billing software to require modifier -TH for all maternity visits starting 2026-09-01 - Providers must document medical decision making or time-based visit complexity - For pre-9/1/26 dates of service: Continue using codes 59425 (4-6 visits) and 59426 (7+ visits) 5. Immediately: Billing team must ensure contraceptive counseling/management visits use diagnosis codes from preventive guide's Preventive Gynecologic and Wellness Exam for Contraceptive Management section as primary diagnosis. Update encounter forms to require diagnosis selection from this specific list. Claims with misaligned diagnoses may lose member cost-share coverage eligibility. 6. By 2026-12-31: Ensure all Vermont Blue Advantage (VBA) claims for 2025 services are submitted by deadline. After 12/31/26, claims will be denied. Fax to (800) 479-8973. 7. Ongoing: Maintain strict 180-day timely filing compliance for all claims. Verify claim receipt in Provider Resource Center or wait 30 days after submission before requesting status updates. 8. Immediately: If practice uses third-party billers or vendors, ensure they are formally authorized with Blue Cross VT. Provider must have business associate agreement and provide proof upon request per Provider Handbook Section 6.1. 9. Immediately: Do NOT contact Blue Cross VT using AI-generated inquiries or automated calls. Use only live provider relations contact: (888) 449-0443, option 1 or providerrelations@bcbsvt.com.