Covid-19 Updates

March 31, 2021

Streamlined Admission Process for COVID Patients Extended Through April 30

As hospitals across the state are caring for patients admitted with COVID-19, Blue Cross and Blue Shield of Alabama is continuing to improve needed access for patients.

We are extending the process to streamline admissions for the following facilities:

• Long-term acute care hospitals (LTACH) for all Blue Cross and Blue Shield of Alabama members with one or more specified diagnoses.
• Skilled nursing facilities (SNFs) specifically for Blue Advantage^® members with one or more specified diagnoses who require an acute inpatient admission.

This streamlined process for SNF and LTACH admissions extends through April 30, 2021.

Visit our COVID-19 Treatment page for additional details.

March 10, 2021

Janssen COVID-19 Vaccine Information Available

Our COVID-19 Vaccines page includes new information related to the Janssen vaccine that has received emergency use authorization from the U.S. Food and Drug Administration.

Important note about Blue Advantage^® members: Providers administering COVID-19 vaccines to Blue Advantage members must submit those claims to the CMS Medicare Administrative Contractor (MAC) for payment.

February 10, 2021

Updated: COVID-19 Vaccine Information for Providers

Our new COVID-19 Vaccines page contains coding information and other resources for providers, including a link to frequently asked questions and answers. We will update this webpage as new vaccines are approved for use and new information becomes available, so please bookmark it and check it often.

New ICD-10 Codes Related to COVID-19 Conditions

Effective January 1, 2021, the Centers for Disease Control and Prevention (CDC) implemented new ICD-10 diagnosis codes that can be used to identify conditions resulting from COVID-19. Our COVID-19 Treatment page includes other codes approved for use by the CDC related to COVID-19.

February 5, 2021

Important COVID-19 Message from our Medical Directors

COVID-19 continues to cause alarming rates of hospitalizations, severe illness, even death. Vaccines are critical to address this ongoing public health crisis. That’s why frontline healthcare workers – physicians, clinicians, nurses, pharmacists and others – have been given vaccination priority.

Please read this message from Blue Cross and Blue Shield of Alabama Medical Directors about the importance of healthcare workers getting vaccinated and, as the availability of vaccines increases, encouraging their patients to do the same.

Refer to our COVID-19 Vaccine page for a list of current vaccine codes and other vaccination-related information.

January 29, 2021

COVID-19 Testing for Surveillance Purposes Not Covered

As COVID-19 vaccines increasingly become available to the public in Alabama, we want to remind providers that testing for surveillance purposes is not covered, whether conducted separately or in conjunction with the vaccine administration. We do not cover COVID testing to determine vaccine effectiveness.

As stated on our COVID-19 Testing page, here are the coverage guidelines:

Covered

Medically Appropriate COVID-19 Testing – Testing to detect or diagnose COVID-19 in an individual when there is presence of a potential COVID-19 symptom or actual or suspected exposure to a person with COVID-19.

Non-Covered

Surveillance COVID-19 Testing – Testing for patients to return to work or school to rule out the possibility of COVID-19 in the absence of symptoms or exposure. Federal government guidance on this legislation issued June 23, 2020, states that group health plans and insurers are not required to pay for COVID-19 tests that are ordered for surveillance purposes. 

December 15, 2020

Codes Available for COVID-19 Vaccines and Monoclonal Antibodies 

Codes for COVID-19 vaccines and monoclonal antibodies as well as their administration have been published on our COVID-19 Treatment page. Vaccine codes are effective after the U.S. Food and Drug Administration approves the vaccine for emergency use.

Important note about Blue Advantage^® members: Providers administering COVID-19 vaccines to Blue Advantage members must submit those claims to the CMS Medicare Administrative Contractor (MAC) for payment.

December 15, 2020

CPT Code 99072 Not Billable 

We do not reimburse providers for CPT code 99072, which is defined as: “Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service(s), when performed during a Public Health Emergency as defined by law, due to respiratory-transmitted infectious disease.”

Code 99072 has been added to our List of Procedures and Services Not Separately Paid, which outlines CPT and HCPCS codes that are not separately payable services.

December 9, 2020

DME Update: Oxygen Therapy

In response to the ongoing COVID-19 public health emergency, the suspension of the oxygen saturation requirement for both certification and recertification has been extended through the end of the federal public health emergency.

Refer to our COVID-19 Treatment page for additional treatment information.

December 4, 2020

Important Telehealth Policy Update

In response to the ongoing COVID-19 pandemic, expanded telehealth services coverage for eligible Blue Cross members including Blue Advantage^® will continue through the end of the federal public health emergency. Continue to check our COVID-19 Provider Update Center for important announcements.

Because benefits can vary depending on a member’s plan, it’s important to always check eligibility and benefits through ProviderAccess or your practice management system to confirm coverage and cost-sharing details.

September 8, 2020

Avoid Common COVID-19 Billing Issues

During our response to the COVID-19 pandemic, we have not waived standard documentation or medical necessity policies. It is important that providers review medical record documentation and avoid the following common inappropriate billing scenarios: 

• Do not bill specimen collection HCPCS code G2023 with a Level 2 or higher evaluation and management (E/M) service. The specimen collection is included with the E/M service.
• Do not bill a Level 2 or higher E/M code if the patient is not seen by a billable practitioner.
• Do not submit a claim for a telehealth visit if:
  • the phone call is part of normal practice operations (scheduling, refill request with no changes),
  • the billing practitioner does not personally speak to the patient, or
  • the minimum medical necessity and documentation requirements are not met during the call.

September 8, 2020

COVID-19 Panel Testing 

As the demand continues for COVID-19 testing, we are advising providers that panel testing should be ordered only if it is medically necessary for the patient. Routinely performing respiratory panels is not appropriate in the absence of supportive clinical symptoms. In most cases, only a specific test to determine the presence of COVID-19 is needed.

At some point in the near future, medical necessity reviews may be used to determine if panel tests given to patients were needed. Providers who order panel tests should note in the medical record the reason for such a test.

Refer All Tests to In-Network Laboratories

All Blue Cross and Blue Shield of Alabama participating providers are required per their contract to refer to in-network laboratories. A list of in-network labs is available at AlabamaBlue.com/providers/FindALab.

Review our COVID-19 Testing page for additional information, including our guidance on surveillance vs. diagnostic testing coverage.

July 30, 2020

Dispensing Limits on Hydroxychloroquine, Chloroquine and Azithromycin Discontinued

Dispensing limits on these drugs will be discontinued as of August 1, 2020. For more information, see our COVID-19 Treatment page.

July 29, 2020

Attention Blue Advantage^® Providers: Use Appropriate Codes for Telehealth E/M Services

Providers must use correct codes to indicate whether audio and video equipment or audio only was used when performing evaluation and management (E/M) services via telehealth for Blue Advantage patients. Refer to our Telehealth Coverage Guidelines page for details.