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PAP202

Claim Submission Requirements


Provider Administrative Policy

Section
Claims Submission
Policy Date
February 2008
Status/Date
Revised/November 2010
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

Claim Submission Requirements

Please refer to the table below for the billing format required when submitting claims for the given provider type.

Provider TypeCMS1500UB-04CPT ICD9Rev ICD
Advanced Practice Nurses  
Ambulance - hospital based 
Ambulance - non-hospital  
Approved Diabetic Education Programs
Hospitals  
Clinic based providers  
Audiologists  
Chiropractor  
Counselor (LCPC)  
CRNA  
Diagnostic Imaging  
DME  
Home IV  
Home Health prior to 01/01/2010•   
Home Health effective 01/01/2010 
Hospice  
Inpatient Hospital  
Outpatient Hospital 
Professional Hospital  
Licensed Marriage and Family Therapist (LMFT)  
Lithotripsy  
Nurse Practitioner  
Occupational Therapist  
Physician  
Physician Assistant  
Physical Therapist•*  
Podiatrist  
Psychiatric Inpatient  
Psychiatric Professional  
Psychologist  
Registered Dietician

 •

 

 •

 
Service Extender  
Skilled Nursing Facility (SNF)  
Sleep Laboratory

 

• 

 
Social Worker (LCSW)  
Speech Therapist  
Surgery Center  
Vision  

* Physical therapy claims billed to Blue Cross of Idaho that are secondary to Medicare should be billed on a UB-04 if instructed to do so by Medicare. All covered providers are contingent on the member`s contract.

Claims Mailing Address
P.O. Box 7408
Boise, ID  83707


Policy History

Date Action Reason
November 2010 Revised Added sleep labs and registered dieticians
January 2010 Revised Home health billed on UB04
May 2008 Revised Grid revised

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