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Diagnosis and Procedure Codes


Provider Administrative Policy

Section
Claims Submission
Policy Date
February 2008
Status/Date
Revised/February 2014
Provider Type(s)
All Providers  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts


Policy

Diagnosis and Procedure Codes

Diagnosis codes are updated in annually in October. Please use the new codes as of October 1. Remember to remove the decimal point in the diagnosis codes for electronically submitted claims. For example, you should enter 250.00 as 25000.

Procedure codes are updated quarterly throughout the year. Blue Cross of Idaho makes every effort to comply with release schedules to add new and revised codes as they are published. If we encounter unreasonable delays in implementing code updates, Blue Cross of Idaho will work with providers to coordinate claims activities by pending, reprocessing or requesting resubmission of claims.

When submitting a claim for services, please use the appropriate diagnosis and procedure codes. We recommend keeping the previous coding manuals for at least a year after the new ones are obtained. You may also obtain quarterly updates to the codes from the CMS Web site at http://www.cms.hhs.gov/QuarterlyProviderUpdates.

The Noridian Web site may also be of assistance with coding questions at  http://www.noridianmedicare.com

If you need a coding manual, they are available for purchase at bookstores, through the Idaho Medical Association (IMA) or online. Code information is also available in the provider section on the Blue Cross of Idaho Web site at bcidaho.com.

 


Policy History

Date Action Reason
February 2014 Revised Language revision
May 2013 Revised Change reference to Cigna's website to Noridians
January 2012 Revised Added wording related to implementing code updates.
May 2008 Revised Electronic submission added

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