Billing News

Blues highlight medical, benefit policy changes

Procedures for which BCBS Michigan has changed a billing guideline or added a new payable group will appear under Updates to Payable Procedures.

86304 Basic Benefit Policy

CA-125 remains experimental for asymptomatic patients as a screening technique and remains payable for patients who meet specified criteria. Those inclusionary guidelines have been updated, effective Nov. 1, 2011.


Because there is no code for this service, the above procedure should be reported with this not otherwise classified code.

Basic Benefit Policy

Genetic testing for arrhythmogenic right ventricular cardiomyopathy (ARVC/D) is payable for URMBT members when inclusionary guidelines are met, effective June 1, 2011.

S3860-S3862 Basic Benefit Policy

The safety and effectiveness of genetic testing for cardiac channelopathies, including long QT syndrome (LQTS), Brugada syndrome and other variants, have been established. It may be considered a useful diagnostic option when indicated for patients meeting specified guidelines, which have been updated, effective Nov. 1, 2011.

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