Coronavirus (COVID-19) Provider Update Center
Blue Cross is closely monitoring the outbreak of the Coronavirus Disease 2019 (COVID-19) and will publish information and updates on this page.
The Centers for Disease Control and Prevention (CDC) and ADPH have published guidance for healthcare providers. Blue Cross encourages our providers to follow the published guidelines from the ADPH and CDC for preparedness, symptom evaluation and reporting.
May 28, 2020
Patient-Specific COVID-19 and Telehealth Coverage and Cost-Share Information
COVID-19 and telehealth coverage and cost-sharing amounts (deductibles, copayments, etc.) can vary among Blue Cross members. Always check eligibility and benefits through ProviderAccess or your practice management system to confirm patient-specific details.
View our COVID-19 and Telehealth Benefits Guide to learn where to find this coverage and cost-sharing information for your Blue Cross and Blue Shield of Alabama patients.
May 22, 2020
DME Update for Oxygen Therapy
In response to the COVID-19 Public Health Emergency, we are suspending the oxygen saturation requirement for both certification and recertification for 60 days, effective April 1, 2020. This action will not be extended beyond May 31, 2020.
Updated May 21, 2020
We have updated the “Laboratory Testing” section of our COVID-19 Coding Guide to include the following:
Blue Cross and Blue Shield of Alabama is working with providers to ensure access to affordable care during this crisis. We encourage out-of-network providers to accept our payment for COVID-19 testing as payment in full and work together with us to protect our members from financial harm.
Our coding guide outlines a summary of the coding instruction provided by the CDC, World Health Organization and CMS.
Updated May 15, 2020
Telehealth Coverage Expansion
We updated our Telehealth Billing Guide to include the following:
Our expanded Telehealth Coverage Guidelines are effective starting March 1, 2020, and are now set to expire on June 30, 2020. We will continue to evaluate to determine whether a further extension is needed.
May 12, 2020
Coronavirus Codes Added to List of Services Carved Out of EAPG Pricing
The Services Carved Out of EAPG Pricing document has been updated with three coronavirus HCPCS codes and their corresponding fees.
Updated April 28, 2020
FDA Warns About Hydroxychloroquine or Chloroquine for COVID-19
The Food and Drug Administration (FDA) is cautioning against the use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems.
In an April 24 statement, the FDA noted reports of serious heart rhythm problems in patients with COVID-19 treated with hydroxychloroquine or chloroquine, often in combination with azithromycin and other QT-prolonging medicines. The agency also pointed to increased use of these medicines through outpatient prescriptions.
“Hydroxychloroquine and chloroquine have not been shown to be safe and effective for treating or preventing COVID-19,” the FDA said in the statement, which provides detailed information about the safety warning.
Caution About Use of Hydroxychloroquine (Plaquenil) to Treat COVID-19
With the recent increased interest in the use of hydroxychloroquine (Plaquenil) and chloroquine to treat patients diagnosed with COVID-19, various agencies are advising that research is not available to support the use of these medications for treating the novel coronavirus. Also, because the side effects are well known and potentially serious, the ratio of risk-to-benefits is currently not favorable.
The following resources provide information about use of these medications for COVID-19:
Dispensing Limits on Hydroxychloroquine, Chloroquine and Azithromycin
In response to the COVID-19 Public Health Emergency, Blue Cross has implemented the following dispensing limits:
Members currently prescribed these drugs prior to the above effective dates will be able to continue without interruption; however, new prescriptions will be subject to the dispensing limit in order to prevent the risk of stockpiling.
Updated April 27, 2020
Attention Hospitals: Blue Advantage Readmission Review Program on Hold
In response to the COVID-19 pandemic, we have decided to postpone medical record requests for the Blue Advantage Readmission Review Program. This action will remain in place until further notice.
Note: You may receive requests related to other Blue Cross medical review programs, which are unaffected by this action. When we reinstate our medical record requests for the Blue Advantage Readmission Review Program, we will review records for all 2020 dates of service.
The Readmission Review Program is a post-payment audit of claims for Blue Advantage patients who are readmitted to the same acute inpatient facility or from a post-acute setting back to the same inpatient facility within 30 days of discharge. See our Frequently Asked Questions document for more information.
April 20, 2020
Blue Advantage® Home Health Services Update
Blue Cross is following CMS’ home health modifications that allow nurse practitioners, clinical nurse specialists or physician assistants to perform the following for Blue Advantage patients:
This update is included in the online document Home Health Agencies: CMS Flexibilities to Fight COVID-19 and is intended to help patients receive the care they need in a timely manner. It requires that the provider types mentioned above are working in accordance with state law.
April 17, 2020
Blue Advantage® Telehealth Requires Audio-Video Technology
Effective April 21, 2020, Blue Advantage telehealth services will require providers to use audio AND video capability for the visits. If possible, it is recommended to begin using video immediately.
We have updated the approved telehealth procedure list for Blue Advantage in our Telehealth Billing Guide, which provides additional information.
We do understand that some patients may not have access to video equipment. The patient's medical record encounter documentation should note that services were rendered via audio telecommunications only due to the patient not having access to video capabilities.
The U.S Department of Health & Human Services has issued a Notification of Enforcement Discretion for Telehealth specific to the Public Health Emergency declaration resulting from the COVID-19 pandemic.
While Blue Cross encourages providers to use HIPAA-compliant technology, we understand that some providers may rely on the flexibility provided in the notice. Blue Cross will discontinue allowance of the HHS flexibility once the declared Public Health Emergency has ended.
April 14, 2020
"COVID-19 Telehealth Coding & Documentation Tips" Video and CEU Exam Available
You can now view a recording of our Timely Topics webinar, "COVID-19 Telehealth Coding & Documentation Tips," featuring Kim Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO, also known as “Kim the Coder.” Kim provides best practices for coding and documentation related to our expanded Telehealth Coverage Guidelines during the COVID-19 Public Health Emergency.
This program has the prior approval of AAPC for one continuing education unit (CEU). Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.
April 3, 2020
Guidance on Use of Serologic Antibody Tests for COVID-19
As interest grows in the use of serologic antibody tests for COVID-19, guidance advises that an antibody test is not appropriate to diagnose an acute infection. Serologic antibody testing should not be used as the sole basis for diagnosis and can only aid in the diagnosis of patients in conjunction with a medical review of symptoms and results of other laboratory tests.
Serologic antibody testing specific for COVID-19 can reveal if a patient has been exposed to the virus and had an immune response to the virus; however, it will not reveal if the patient is currently infected.
COVID-19 diagnostic testing by means of a nasopharyngeal swab will provide a determination whether a patient has the SARS-CoV-2 virus present and is capable of spreading the virus to others.
For initial diagnostic testing for COVID-19, the CDC recommends collecting and testing upper respiratory tract specimens (nasopharyngeal swab). The CDC also recommends testing lower respiratory tract specimens, if available. Additionally, CDC guidance indicates that, for patients who develop a productive cough, sputum should be collected and tested for COVID-19.
March 31, 2020
Telehealth Billing Reminder: Use Approved Codes to Avoid Rejected Claims
We have noticed that some claims for telehealth services were filed with CPT codes 98966-98968 or 99441-99443. Although these are valid CPT codes, they are not included in our COVID-19 expanded Telehealth Coverage Guidelines.
If you notice a rejected claim that was originally submitted with one of the above codes, file a new claim with one of the approved codes from our Telehealth Billing Guide and place of service 02 (telehealth).
March 27, 2020
Updated State Lab Requirements for COVID-19 Testing
The Alabama Department of Public Health (ADPH) recently announced updated COVID-19 testing requirements for specimens processed by the state's Bureau of Clinical Laboratories (BCL). Continue to check the ADPH website for the latest information about COVID-19 testing.
March 25, 2020
FDA Warns About Fraudulent Test Kits for COVID-19
The Food and Drug Administration (FDA) recently announced concerns about unauthorized, fraudulent test kits that are being marketed to test for the novel coronavirus (COVID-19) in the home. As of March 20, 2020, the FDA had not authorized any at-home test for COVID-19.
Blue Cross will cover COVID-19 diagnostic tests that are consistent with CDC guidance. To ensure testing accuracy, a specimen must be obtained and appropriately processed for testing by or under the direct supervision of a licensed medical professional.
As the COVID-19 outbreak continues to develop, we are receiving information about an increasing number of healthcare scams related to this emergency situation. We recommend providers evaluate any new services that are recommended for their patients to ensure that they’re legitimate and approved by the federal agencies and covered by Blue Cross.
March 11, 2020
We have prepared contingency plans to ensure business operations continue to run smoothly in the event of an outbreak in Alabama. This means providers and their patients who are Blue Cross members will continue to receive the highest quality service possible from us.
To help ensure that your patients who are Blue Cross members have an ample supply of their medications in the event of a coronavirus emergency, early-refill restrictions that are standard in our pharmacy management safety edits will be temporarily removed.