COVID-19 Billing Guidance – UPDATE!

COVID-19 Billing Guidance – UPDATE!

In order to ensure the proper cost share waiver of your COVID-19 testing claims, BCBSWY asks that providers include specimen handling codes on the claim if you are not performing these tests in-house. Providers can submit a corrected claim if these services were performed but omitted from previous claims.

Acceptable specimen handling codes are: G2023, G2024, C9803, 99000, and 99001. See COVID-19 Billing Guide for more details.

Please do not bill nurse level visits (99201 and 99211) in lieu of specimen collection codes, as these codes may not be properly identified as requiring cost share waivers.

For claims with treatment of COVID-19 defined as U07.1, BCBSWY will waive inpatient prior authorization requirements. Cost share waivers are dependent on a member’s benefit plan – see below for more information.

BCBSWY COVID-19 Response

Telemedicine

Because the health and safety of our community is of upmost of importance, BCBSWY continues to encourage telemedicine visits.

  • BCBSWY has extended our telemedicine benefits, including waiving member cost share,
    effective until August 31, 2020. Expanded telemedicine benefits include all BCBSWY fully
    insured members but is optional for self-funded plans.
  • For additional information on how BCBSWY is processing telemedicine benefits view this matrix.

COVID-19 Treatment

  • BCBSWY has extended our commitment to waive all member cost sharing and copayments for treatment, and inpatient hospital admissions, due to the diagnosis of COVID-19 for all fully insured members but is optional for self-funded plans, effective 4/1/20-8/31/20.

COVID-19 Testing & Billing

The Families First Coronavirus Response Act (the FFCRA) and the Coronavirus Aid, Relief, and
Economic Security Act (the CARES Act) require health plans to cover diagnostic testing of COVID-19.

  • Coverage must be provided without any cost-share, prior authorization, or medical management requirements.
  • View our billing guidance to understand which billing codes are appropriate for testing services.
  • Antibody testing is appropriate as a diagnostic test in limited circumstances and will not be a benefitable service when conducted for return to work or surveillance purposes.
  • Asymptomatic and pre-surgical COVID-19 diagnostic testing is covered when medically appropriate and supported by the accepted standards of current medical practice.

Stay Informed!

  • Very soon BCBSWY will be launching a new public website. Our web address will stay the same, www.BCBSWY.com, but the look will be updated and provider information will be organized by clinical resources and office resources. It’s intuitive to use and we hope you can easily find what you need but let us know if you need help finding something!

For more information see: CDC COVID-19 or State of Wyoming COVID-19.

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