01Already effective September 1, 2017: Providers must report the ordering provider's name in CMS-1500 box 17 and the Type 1 NPI in box 17b, or in the 2310A Loop, NM109 segment for electronic submissions.
02When the ordering provider also performs the service, enter that provider's information in boxes 17 and 17b.
03For integumentary services, do not report a separate E/M service for the decision to perform a minor surgical procedure, and report modifier 25 only for a significant, separately identifiable E/M service that is above and beyond the procedure and stands on its own merit.
04CPT 11100 and 11101 should not be reported separately when a lesion is removed, and only one removal code may be reported for a lesion.
05Simple repairs 12001 through 12021 are integral to lesion removal codes and are not reported separately with them.
06CPT 40490 and 11100 are mutually exclusive when performed at the same anatomic site at the same encounter.
07Claims can be subject to pre-pay and post-pay audit, as well as possible recoveries.
08Already effective September 1, 2013: Claims for occupational, physical and speech therapy must have the applicable HCPCS level II modifier appended.
09Already effective October 1, 2017: Removal of vagus nerve blocking therapy stimulation devices (CPT 0314T and 0315T) requires prior authorization for BlueCHiP for Medicare and commercial products.
10Already effective November 1, 2017: CPT 69209 and 69210 are covered but not separately reimbursed for BlueCHiP for Medicare and commercial products.
11Already effective January 1, 2018: Preauthorization is no longer required or recommended for speech therapy services for BlueCHiP for Medicare and commercial products.
12Before establishing a referral relationship, confirm that the provider currently participates in the BCBSRI network; the laboratories that are not participating are Lehigh Valley Toxicology, Mercy Diagnostics, Total Toxicology, U.S. Lab & Radiology, Inc.
13and Quest.
14Already effective September 30, 2017: Expired orders, controlled substance orders and orders with no refills remaining do not transfer to PrimeMail by Walgreens Mail Service.
15Check current applicability before acting on these 2017 items.