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CommercialBilling CodesHigh impact

Medical Policy Update

Blue Cross Blue Shield of Wyoming·WY · Oncology, Internal Medicine, Gastroenterology +3 more·Prior Authorization
Effective date
Sep 1, 2024
We identified it
Jun 19, 2026
Days to comply

Summary

BCBSWY implemented a new medical policy for Home Infusion services effective 9/1/2024. The policy establishes specific billing requirements using HCPCS G-codes and S-codes for different types of home infusion therapy, requires in-person service delivery for reimbursement, and mandates written physician orders with detailed documentation.

Action Required

Action needed
By September 1, 2024: Billing team must update system to use HCPCS G-codes (G0068-G0070, G0088-G0090) for home infusion therapy billing based on drug type and visit status. Update encounter forms to capture written physician orders and detailed service documentation including total time. Configure billing software to require at least one non-oral drug code alongside each G-code. For nutrition infusions, use S-codes with per diem methodology. Ensure claims specify in-person service delivery as remote-only services will not be reimbursed. Appeals without proper documentation will be rejected.

Affected Billing Codes

G0068
G0069
G0070
G0088
G0089
G0090
S9341
S9342
S9343
S9364
S9365
S9366
S9367
S9368
E0779
E0780
E0781
S5497
S5498
S5501
S5502
S5522
S5523
S5517
S5518
S5520
S5521
S9373
S9374
S9375
S9376
S9377
J3490
J3590
J7799
J9999