Feb. 25, 2025
Coding and Compensation Policies describe payment rules and methodologies for Current Procedural Terminology (CPT®) codes, Healthcare Common Procedure Coding System and ICD-10 coding for claims submitted as covered services. This information is a resource for our payment policies. It’s not intended to address all reimbursement-related issues. We regularly add and modify coding and compensation policy positions as part of our ongoing policy review process.
The following policies were updated:
- Non-Reimbursable Experimental, Investigational and/or Unproven Services policy, effective May 15, 2025
- Health Screening Vendors Compensation Policy, effective April 4, 2025
- Anesthesia Compensation Policy, effective April 15, 2025
The following lab management policies were updated:
- CPCPLAB003 Vitamin D, effective April 15, 2025
- CPCPLAB004 Diabetes Mellitus Testing, effective April 15, 2025
- CPCPLAB008 Diagnostic Testing of Iron, effective April 15, 2025
- CPCPLAB009 Testosterone, effective April 15, 2025
- CPCPLAB010 Vitamin B12 and Methylmalonic Acid Testing, effective April 15, 2025
- CPCPLAB020 Cardiovascular Disease Risk Assessment, effective April 15, 2025
- CPCPLAB023 Diagnosis of Idiopathic Environmental Intolerance, effective April 15, 2025
- CPCPLAB028 Immune Cell Function Assay, effective April 15, 2025
- CPCPLAB032 Oral Cancer Screening and Testing, effective April 15, 2025
- CPCPLAB038 Urinary Tumor Markers for Bladder Cancer, effective April 15, 2025
- CPCPLAB045 Pathogen Panel Testing, effective April 15, 2025
- CPCPLAB051 Diagnostic Testing of Common Sexually Transmitted Infections, effective April 15, 2025
- CPCPLAB057 Coronavirus Testing in the Outpatient Setting, effective April 15, 2025
- CPCPLAB067 Testing of Homocysteine Metabolism-Related Conditions, effective April 15, 2025
- CPCPLAB069 Immunohistochemistry, effective April 15, 2025
For more details, refer to the revised policies in Availity® Essentials through the Plan Documents Viewer application. You can access the application in Payer Spaces for Blue Cross and Blue Shield of Montana.
CPT copyright 2024 American Medical Association. All rights reserved. CPT is a registered trademark of the AMA.
Coding and Compensation Policies are based on using healthcare professionals and industry standard guidelines. The coding and compensation guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers.
The information provided does not constitute coding or legal advice. Physicians and other health care providers should use their own medical judgment based upon all available information and the condition