Change Healthcare Cybersecurity Incident Impact

On Feb. 21, 2024, Change Healthcare announced they experienced a cybersecurity incident. We are not aware of any impact to our systems. However, the implications of Change Healthcare’s incident touch many of our health care partners.

ClaimsXten™ Quarterly Update Effective June 17, 2024

Blue Cross and Blue Shield of New Mexico will implement its second quarter code updates for the ClaimsXten auditing tool on or after June 17, 2024.

See Our Revised Clinical Payment and Coding Policy for Anesthesia Services

What’s changing?
Effective June 1, 2024, BCBSNM is updating its Clinical Payment and Coding Policy, Anesthesia Information (CPCP010).

The Details
Under this revised policy BCBSNM will no longer offer additional reimbursement for services based on the use of physical status (P code) modifiers when appended to anesthesia services.

What do I need to do?
Review in detail the revised policy — Anesthesia Information CPCP010 .

Clinical Payment and Coding Policy Updates

The Clinical Payment and Coding Policies on our website describe payment rules and methodologies for CPT, HCPCS and ICD-10 coding for claims submitted as covered services. This information is a resource for our payment policies. It is not intended to address all reimbursement-related issues. We regularly add and modify clinical payment and coding policy positions as part of our ongoing policy review process.

The following policies were updated:

Caring for Substance Use Disorders

Providers can play an important role in our members’ care by discussing the signs of substance use disorder and encouraging help, if appropriate. We track quality measures related to substance use disorders to monitor our members’ care, including follow-up visits for SUD.

Webinar on Coding for Medicare Advantage Annual Wellness Visits

Join us for our quarterly webinar on coding for annual wellness visits for Medicare Advantage members. The webinar is April 12, 2024, from 11 to 11:30 a.m. MT. Register here. 

Members of our Coding Compliance team will present information from the Official ICD-10-CM Coding Guidelines, the American Hospital Association Coding Clinic and the Centers for Medicare & Medicaid Services. The webinar includes information on:

If you’re unable to view the Teams registration site, you may need to use a different web browser or clear your browser history. After you register, you’ll receive an email with a calendar reminder and link to the webinar.

This webinar doesn’t offer continuing education credit.

Medicare Advantage Coverage of Skilled Nursing Care and Skilled Therapy Services

BCBSNM reminds providers that skilled nursing care and skilled therapy services may be covered under the Blue Cross Medicare Advantage plan.

RSVP for 2024 Annual Medicaid Provider Training Sessions

BCBSNM is offering in-person and virtual provider training sessions for Blue Cross Community Centennial network behavioral health, long-term care and physical health providers and groups.

EPSDT Insights & Provider Participation

Early and Periodic Screening, Diagnostic and Treatment is designed to address the physical, mental and developmental health of children under 21 years of age who are enrolled in Medicaid. At the core of EPSDT is the well child visit, where the goal of EPSDT is to discover and treat childhood health conditions before they become serious or disabling.

In New Mexico, these screening visits are called the “Tot to Teen Healthcheck”. These “healthchecks” should be occurring from infancy through age 20. They should be regularly scheduled check-ups to help the child’s primary care provider identify any problems early and assist with a treatment plan for the child. Following the Bright Futures/American Academy of Pediatrics schedule  of well child visits and screenings, providers can ensure that infants, children and adolescents are receiving the full benefit of their comprehensive health care coverage.

Learn More About EPSDT Provider Participation. 

Increasing Access to Health Care One Care Van Visit at a Time

In 2023, BCBSNM’s two Care Vans visited 50 towns and cities across New Mexico, providing access to no-cost services to more than 13,000 adults, seniors and children.

BCBSNM Breaks Ground on Blue Door Neighborhood Center^SM

Located in Albuquerque’s South Valley, the BDNC^SM will offer members and the community access to in-person resources to improve their health and wellness at no cost.

Provider Engagement at BCBSNM

From left, Tricia MacLaughlin, Sr. Provider Relations Representative, Amanda Garcia and Denise Cox with Perinatal Associates of New Mexico. MacLaughlin visited Garcia and Cox during a provider visit on Jan. 30.