Medical Policy Group, January 2020 (4): Removed policy statements effective for dates of services on or after July 6, 2014 and prior to August 22, 2016.No other changes to policy statements. ALL Babies uses Blue Cross Blue Shield of Alabama (BCBSAL) to provide medical, and mental health and substance abuse services through their preferred provider network (PPO). Medical Policy Administration Committee, September 2016, Available for comment August 23 through October 6, 2016. Prediction and Prevention of Preterm Birth. The Telehealth Billing Guidecontains a list of approved CPT codes and providers eligible to bill for them under our expanded Telehealth Coverage Guidelines for COVID-19. Physicians should always exercise their best medical judgment in providing the care they feel is most appropriate for their patients. Just starting your journey? preterm birth <34 wks or spontaneous/unexplained PROM <34 wks meets criteria. All Rights Reserved. You can enroll any time and your coverage begins immediately. Blue Cross and Blue Shield Service Benefit Plan www.fepblue.org 2023 . All rights reserved. maternity codes to further specify the condition(s). The decision of whether or not to have a certain test, treatment or procedure is one made between the physician and his/her patient. Twin Pregnancy. Maternal Health Supporting mothers and babies through every stage of pregnancy. Maternity. 0000018009 00000 n Blue Cross Blue Shield conspired to fix prices for health insurance, Ford Motor Co. alleged in a lawsuit filed in federal court in Detroit on Wednesday. Other payers, such as CMS, may refer to these terms more broadly or even interchangeably. Whats new in prenatal screening and diagnosis? The plan does not approve or deny procedures, services, testing, or equipment for our members. December 20, 2021. The PHE expired on May 11, 2023. The most recent Blue Cross Blue Shield, The Health of America Report on maternal health trends found that an increasing number of women are experiencing pregnancy and childbirth complications, as well as postpartum depression. Baby Yourself - free gifts and a personal nurse offer support for a healthy pregnancy; In patients with abnormal AFP, if the ultrasound at 16-22 weeks gestation is normal, it is not medically necessary to repeat the ultrasound in the absence of any other indications. $ v^tT9LpE%LgcXV7Ej+}W3KIItUG]NAz#9eq,q0 %AU4'[?yt "9=llkAO?"`M2+GUQy-j}3`[t)U%I)wR:r|'='#''9IuI'FJF*F*GF*F?t$(|7>zvl_`#r New patient quality measurements aim to improve care for mom and baby, Lowering costs for patients with team approach to quality care, After Aspen: Driving health equity action, Blue Cross Blue Shield companies are creating supportive interventions for mothers-to-be, The Health of America Report on maternal health trends, BCBS companies are promoting maternal health equity, In Texas, when an expectant mother with a high-risk twin pregnancy entered. 0000022051 00000 n Exclusive discounts on BenefitsPRO.com and ALM events. The PHE expires May 11, 2023. @EfoJR$ehK-WOyfJ G^{%:(UsKm[ &y\vXqWOGj{=FyT-X&0A/ .3;YRw$K!=.a6Uy\Fx6,iD='D! B ea80u?oIG( THK001ogf4am0Sab:YIa26 5Rv+fr,I :0 No change to policy statements. (At Risk and All Pregnant Women) Age 10 and older HIV Infection Prevention: Pre-exposure Prophylaxis (PrEP) . Please refer to the Telehealth Billing Guide for eligible providers. See "Explained: Telehealth vs. Telemedicine" for an explanation ofhow Blue Cross and Blue Shield of Alabama defines these terms. Number 549; January 2013. Access Your Benefits You can use our interactive search to find your local Blue Cross Blue Shield Company's website. 0000018959 00000 n Submitted by admin on . Medicaid: This federal/state government health insurance program provides free or low-cost health coverage to pregnant women who qualify based on income. CPT codes 99441-99443 should be reported for audio-only evaluation and management services. Applicable FARS/DFARS apply. If you purchase something through links we may earn a commission. No 169, October 2016. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Medical Policy Administration Committee, May 2014, Available for comment May 22 through July 5, 2014. J^"dSD4qjPK]zjfNMA&#=?u@GmnJ=;K; D,0QF(qM[`WbE7!4(2Hf7@\Ci Maternal Health Pregnancy Care Incentive Program A healthy pregnancy is just the beginning We're dedicated to supporting healthy pregnancies, from early prenatal care in your first trimester all the way through childbirth and the months that follow. 0000047818 00000 n HWEWSG|x%FH'2wvYWgdUw~CQo/~mRO_>|=xT6KE_ZJ[{TfUuF}BY'nn/k'wku"}?7G5;&_|(6u8\Kqul7p]4 KRh@UO08Ix+V\.*+x&Z` ^j&V[^7$,qpdClfk^u_]H+-UZCRPXt]:C*7p9@i$qYD)J!ZZAR{x?b Vrm~y'#;n:cS~gj:;pv-nhp]A39Wy*M%'hvb j-Pz\!R@:]M<2kF*O>U.@huv+ 0000019955 00000 n 0000001276 00000 n Q: What is the difference between telehealth and telemedicine? The rates shown assume all Gaps In Care are complete and is the lowest rate possible. Precertification is required for many services, including the following outpatient hospital benefits, physician benefits and other covered services. 229; Interim update, June 2021. American Medical Association Current Procedure Terminology (CPT). Does Blue Cross Blue Shield Cover a Breast Pump? Radiolog Clin of North Am 2003; 41(4). As a general rule, benefits are payable under health plans only in cases of medical necessity and only if services or supplies are not investigational, provided the customer group contracts have such coverage. Employers Find the right plan for your employees. Racial and Ethnic Disparities in Maternal Health. 229 - Antepartum Fetal Surveillance. 0000010155 00000 n BCBS develops medical necessity standards to aid BCBS when making medical necessity determinations. Maternity care . $169.32. Option 1: Stay on Your Parents' Health Insurance Plan Under the Affordable Care Act, young adults can choose to stay on their parents' health insurance plan until they turn 26 no ifs, ands or buts. Code 76815 represents a focused quick look exam limited to the assessment of one or more of the elements listed in the code. Added sickle cell anemia and substance abuse beneath non-routine ultrasounds. Dichorionic: Serial ultrasounds every 4-6 weeks beginning at 20 weeks. As part of the cardiac screening examination, an attempt should be made if technically feasible, to view the outflow tracts. In those cases, if the non-routine ultrasounds are performed between 6-10 weeks or 16-20 weeks gestation, they should yield information regarding dating and fetal anatomy. FULL TIME EMPLOYEES. Always check eligibility and benefits through ProviderAccessor your practice management system to confirm coverage and cost-sharing details. Maternity Program . You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by HealthEquity. niXF2bi=B Coverage is subject to members specific benefits. 0000000016 00000 n While data shows troubling trends in maternal health for the U.S., Blue Cross Blue Shield companies are creating supportive interventions for mothers-to-be. 0000044264 00000 n A plan built for two A plan to cover what you both might need The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield Companies. However, Blue Cross and Blue Shield Federal Employee Program(BCBS FEP) uses modifiers for certain telehealth claims. All medical policies are based on (i) research of current medical literature and (ii) review of common medical practices in the treatment and diagnosis of disease as of the date hereof. Follow up ultrasounds for asymptomatic placenta previa noted on ultrasound is considered not medically necessary until the third trimester and only if the placenta previa is complete or marginal on a previous ultrasound. It's never been more important to make sure you get every benefit available. No additional activities are required to earn the waiver. Ultrasounds in excess of two for normal pregnancy are considered not medically necessary. But employers are in a powerful position to address the health inequities and social determinants that shape those statistics. Over 700 women die of pregnancy-related health issues every year. Medical Policy Group, March 2017 (4): Update to References and policy statement, adding specific criteria for monochorionic and dichorionic twins regarding ultrasounds. P.O. Our decisions concern coverage only. Include the condition being treated and document that it is not affecting the pregnancy. 0000004061 00000 n Three-dimensional ultrasound of the fetal spine. A personal nurse to answer questions during and after pregnancy. A limited examination would be performed to confirm fetal heart activity in a patient experiencing vaginal bleeding or to establish fetal presentation in a laboring patient. If you want to stay on the Blue Cross website, click "Cancel.". Q: Does Blue Cross require modifiers for telehealth (95/GT/GQ) or disaster/crisis (CR)? Follow up ultrasound for non-routine (high-risk) conditions possibly affecting the outcome of the pregnancy may be considered medically necessary. Below is a list of possible warning signs: To learn more about the HEAR HER campaign, visit CDC.gov/HearHer for free information, related resources and learning materials. No 145, July 2014 (Reaffirmed 2019). CPT codes, descriptions and data copyright BCBSPREVIOUSYEAR American Medical Association. Credence BCBS is a new, geographically neutral experience available to these specific National Account groups. Obstet Gynecol 1997; 89:434-8. Antepartum Fetal Surveillance. (See Key Points), A detailed or targeted anatomic examination (76811) may be considered medically necessary only when an anomaly is suspected on the basis of history, laboratory abnormalities, or the results of either the limited or standard examination or when the patient is obese as defined by BMI of 30 or greater. Antenatal care of low risk pregnancies: ultrasound, Clinical Evidence 2001, 5:960-971. 0000006311 00000 n 0 Under fetal conditions, added twin-twin syndrome, fetal anemia, and known/suspected genetic or congenital anomaly. The use of three-dimensional (3D) ultrasound (use of CPT codes 76376 or 76377 with 76801-76817) is considered not medically necessary. Report should document the results of the evaluation of each element described above or the reason for non-visualization. To be enrolled in short term coverage, the contract holder must be a resident of the state of Alabama, not enrolled in Medicare or Medicaid, and not currently on a short term limited duration plan. ALL Babies and ALL Kids are administered by Alabama's Children's Health Insurance Program (CHIP) through the Alabama Department of Public Health. Medical Policy Group, April 2022 (4): Updates to Key Points. Please review each section carefully because there are some differences in the codes. Serial ultrasounds every 2-3 weeks beginning at 16 weeks. ALL Kids uses Blue Cross Blue Shield of Alabama (BCBSAL) to provide medical, mental health, and substance abuse services through their preferred provider network (PPO). Q: Are the evaluation and management codes (9921X, 9920X) the correct codes to use for telehealth? Individual consideration will be given to cases where there is specific documentation in the patients medical record to perform both a transvaginal and transabdominal ultrasound on the same date of service. Available at: www.uptodate.com/contents/twin-pregnancy-prenatal-issues?source=search_result&search=twin%20pregnancy:%20prenatal%20issues&selectedTitle=1~150. 0000012870 00000 n SINGLE COVERAGE. 2023, BlueCross and BlueShield of Alabama is an independent licensee of the BlueCross and BlueShield Association. For information about premiums, benefits, and limitations and exclusions for short term plans, please review the Benefit Booklet for Short Term Blue . More than one in-network office, urgent care, emergency room or behavioral health visit, or telehealth service for the same member incurred on the same day will be covered if it is rendered by in-network PPO providers and the claims are filed with a COVID-19 related diagnosis as outlined by the CDC and American Medical Association. 0000003837 00000 n 0000040883 00000 n Public Education Employees' Health Insurance Plan: Blue Cross Blue Shield of Alabama Coverage for: Individual + Family | Plan Type: PPO . ACOG Practice Bulletin. You can choose from a selection of breast pumps and accompanying milk storage bags. No 30, September 2001. If the code has a defined frequency limit, it is noted in the Telehealth Billing Guide. Critical BenefitsPRO.com information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters. The scientific evidence must permit conclusions concerning the effect of the technology on health outcomes; 3. For the first time, scientists say theyve identified 12 distinct symptoms of the post-pandemic era disease, after examining nearly 10,000 Americans in a 4-year study published in JAMA. Q: Are there frequency limits for billing telehealth visits? In accordance with generally accepted standards of medical practice; and, 2. 0000012036 00000 n Thank you for your interest in our Short Term Plan. Alabama Perinatal Excellence Collaborative. Clinical management guidelines for obstetrician-gynecologist, Antepartum fetal surveillance, No. 0000018538 00000 n Ultrasound Obstet Gynecol 2000; 16:321-8. They state that the goal of antepartum fetal surveillance is to reduce the risk of stillbirth. Obesity in pregnancy. Failure of the initial ultrasound to diagnose or confirm suspicions. Eligibility and benefits are determined on a case-by-case basis according to the terms of the members plan in effect as of the date services are rendered. No. For Alabama Blue Cross members, the claim should be filed with a place-of-service code to indicate the service was rendered via telehealth. Blue Cross and Blue Shield of Alabama offers health insurance, including medical, dental and prescription drug coverage to individuals and families. As an Alabama Health Guidance representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. A standard ultrasound examination includes an evaluation of fetal presentation, amniotic fluid volume, cardiac activity, placental position, fetal biometry, and fetal number, plus an anatomic survey. Members and covered spouses enrolled in the PEEHIP Hospital Medical Group #14000 Plan (BCBS) can earn a waiver of the wellness premium by completing a wellness screening between August 1, 2022 and August 31, 2023. While this is the claims-filing process for Blue Cross and Blue Shield of Alabama, this may vary among payers. Check with your insurance carrier to see if these are covered services. (See Key Points). No. To continue to the HealthEquity website, click "Accept." No 101, February 2009. If this coverage expires or you lose eligibility for this coverage, you might have to wait until an open enrollment period to get other health insurance coverage. The SBC shows you how you and the plan would share the cost for covered health care services. Emerg Med Clin of North Am 2004; 22(3). 6 Steps to Support Colleagues Going Through Menopause. Three-dimensional ultrasound in the evaluation of fetal anomalies. 0000016284 00000 n Code 76816 describes and examination designed to reassess fetal size and interval growth or reevaluate one or more anatomic abnormalities of a fetus previously demonstrated on ultrasound, and should be coded once for each fetus requiring reevaluation using modifier 50 for each fetus after the first. As many as 50,000 women a year experience severe, unexpected health problems related to pregnancy. Additional routine ultrasounds are considered not medically necessary. 0000015569 00000 n Per the American Medical Association Current Procedural Terminology (CPT): Codes 76801 and 76802 include determination of the number of gestational sacs and fetuses, gestational sac/fetal measurements, survey of visible fetal and placental anatomic structure, assessment of amniotic fluid volume/gestational sac shape and examination of the maternal uterus and adnexa for fetuses younger than 14 weeks 0 days. Medical Policy Group, April 2023 (4): Updates to Key Points and References. The Telehealth Billing Guide contains a list of approved CPT codes and providers eligible to bill for them under our expanded Telehealth Coverage Guidelines for COVID-19. HealthEquity is our business associate and is an independent company that provides account-based plan services to Blue Cross. 0000001716 00000 n ACOG Committee Opinion. Please see your benefit booklet to determine what services require precertification under your plan. 0000003329 00000 n The improvement must be attainable outside the investigational setting. Known or suspected fetal conditions or abnormalities such as: Evaluating suspected fetal growth abnormality (either less than or greater than for gestational age), and to follow intrauterine growth restriction. Obesity is defined as 100 or more pounds over ideal body weight (as determined by the Metropolitan Height and Weight Table or BMI >30). Previously covered, added for clarification. All rights reserved. 14 49 Ultrasound may provide valuable information about fetal health including: The most recent literature review was updated through April 7, 2023. CDT codes, descriptions and data copyright BCBSPREVIOUSYEARAmerican Dental Association. ), Umbilical cord insertion site into the fetal abdomen, Spine-cervical, thoracic, lumbar and sacral spine, Extremities-legs and arms (presence or absence), Sex-in multiple gestations and when medically indicated in low-risk pregnancies. Lazebnik N, Lazebnik RS. A prospective controlled study of outcome after trauma during pregnancy, Am J Obstet Gynecol 1990, 162:1502-1510. Clinical management guidelines for obstetrician-gynecologist, Ultrasonography in pregnancy. 0000004520 00000 n Blue Cross Blue Shield (BCBS) Insurance Guidelines cover a breast pump and breast pump supplies at no cost to you and your family. Updates to Key Points and References. Transvaginal and transabdominal ultrasounds performed on the same date of service are considered not medically necessary. Visit our Family Planning page for options and more info. Ultrasound Obstet Gynecol 2003; 21:467-72. Travel Explore short or long term international travel coverage options. Download this eBook to learn strategies to affect meaningful change in employee health. Q: What if a patient calls for telehealth and then needs to be seen by the same provider or referred to another provider for a test or follow-up the same day? covered under the plan and when your child's coverage begins. View our COVID-19 and Telehealth BenefitsGuide. The plan administers benefits based on the members contract and corporate medical policies. That means you can stay on your parents' plan whether or not you: Live with your parents Are claimed as a dependent on your parents' taxes preterm birth <34 weeks or spontaneous/unexplained premature rupture of membranes <34 weeks). 0000025882 00000 n In 2021, ACOG replaced Practice Bulletin no. For services provided to Blue Advantage members, there is an audio and visual requirement, effective April 21, 2020. Antepartum fetal surveillance. Q: Is there more information on how/when to use diagnosis code U07.1 for the novel coronavirus? Changes for 2023: Page 15 Summary of Benefits: Page 162 This Plan's health coverage qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides. Below are the biweekly rates for insurance. At this time, Blue Cross and Blue Shield of Alabama does not require the use of a modifier to indicate telehealth or disaster/crisis. Service Benefit Plan members who are pregnant and/or nursing are eligible to receive one breast pump kit per calendar year by logging in to your MyBlue account and ordering the kits online or by calling 1-800-411-BLUE (2583). In some cases, the pregnancy may be considered high-risk during the first two ultrasounds and the patients condition may improve as the pregnancy progresses. While physicians mostly applauded the Preventive Services Task Forces recommendation that women get routine breast cancer screenings starting at 40, down from 50, some doctors and researchers disagree with the data used. HealthEquity has agreed to follow Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information. 2023 Blue Cross Blue Shield Association - All Rights Reserved. 2023, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. Highlights of Alabama Personal Choice The Blue Cross ID card. Mongelli M. First trimester dating by ultrasonography reduced the risk of induction of labour for postterm pregnancy. Some areas of our site may provide links to other external sites that we don't own, control or influence. Medical Policy Group, August 2021 (4): Updates to Policy, Key Points, and References. Chronic hypertension in pregnancy. The following preventive services and immunizations do not apply to all health plans administered or insured by Blue Cross and Blue Shield of Alabama. Q: Is there coverage of behavioral health services provided via telehealth? Therapy for children ages 0 through 18 at 100% of the Blue Cross Blue Shield of Alabama allowance, subject to a $15 copay per visit and the annual dollar maximum limits of $40,000 for ages 0 through 9, $30,000 for ages 10 . Bernaschek G., Ruaelstorfer R., Csaaicsich P. Vaginal sonography versus serum human chorionic gonadotropin in early detection of pregnancy, Am J Obstet Gynecol 1988, 158:608-612. Clinical management guidelines for obstetrician-gynecologist, Assessment of risk factors for preterm birth. $67.72. ^L>DkSdZ. 921 0 obj <>/Filter/FlateDecode/ID[<06FA152C9CADA0489A6B47DE70D4AE2E>]/Index[892 54]/Info 891 0 R/Length 127/Prev 572567/Root 893 0 R/Size 946/Type/XRef/W[1 2 1]>>stream Have your Contact ID ready. 0000033556 00000 n 2/3 of all pregnancy-related deaths are preventable. $kb1$A,v m B@&V "H'L2eHg`bdH? 0000036276 00000 n X_8e3G f;k^K1Wg#ya{ t#nm80QFe%$2 &kff[ k endstream endobj 24 0 obj <>stream (Coverage is based on CDC's Advisory Committee in Immunization Practices . All rights reserved. Not primarily for the convenience of the patient, physician or other health care provider; and, 4. If only a 3D study is performed, the two-dimensional portion of the ultrasound is covered per the above criteria. 0000016659 00000 n SBo Blue Cross and Blue Shield Plans nationwide are implementing various types of cost-sharing waivers as a result ofCOVID-19. Medicare Select Plan Learn more about Medigap, Medicare Supplement and CPlus plans. 175 (2016)- Ultrasounds in Pregnancy. Trends in Pregnancy and Childbirth Complications in the U.S. New patient quality measurements aim to improve care for mom and baby, After Aspen: Driving health equity action, Podcast: Improving maternal health starts before pregnancy, Video: Healthy maternity program improves access to care for mom and baby, BCBS companies support new and expectant mothers, Pediatricians screen new moms for postpartum depression, Lowering chronic disease makes childbirth safer for Mississippi women, Better starts mean better outcomes for South Carolina babies, Using telemedicine to improve rural womens health and save babies lives. We have the answers to all your questions! Medical Necessity means that health care services (e.g., procedures, treatments, supplies, devices, equipment, facilities or drugs) that a physician, exercising prudent clinical judgment, would provide to a patient for the purpose of preventing, evaluating, diagnosing or treating an illness, injury or disease or its symptoms, and that are: 1. Codes 76811 and 76812 include all elements of codes 76805 and 76810 plus detailed anatomic evaluation of the fetal brain/ventricles, face, heart/outflow tracts and chest anatomy, abdominal organ specific anatomy, number/length/architecture of limbs and detailed evaluation of the umbilical cord and placenta and other fetal anatomy as clinically indicated. 145 with no. Use of three-dimensional ultrasound imaging in the diagnosis of prenatal-onset skeletal dysplasias. See Policy #232 for Fetal Biophysical Profile. East Alabama Health covers a portion of your biweekly premium each pay period. Warren W.B., Timor-Tritsch I.E., Peisner D.B., Raju S., Rosen M.G. Your local company can help you to: Change your coverage Estimate the cost of a medical procedure File or check on claim Replace your member ID card Review your balance View your plan details Looking for Insurance? Under fetal conditions, added bcbs of alabama pregnancy coverage syndrome, fetal anemia, and References the! For eligible providers government health insurance, including medical, dental and prescription drug coverage to women. And protection of your personal health information following preventive services and immunizations do apply. Risk factors for preterm birth < 34 wks meets criteria offers health insurance, including bcbs of alabama pregnancy coverage! Precertification under your plan % 20pregnancy: % 20prenatal % 20issues & selectedTitle=1~150 and bcbs of alabama pregnancy coverage... Check with your insurance carrier to see if bcbs of alabama pregnancy coverage are covered services any time and coverage! Many services, testing, or equipment for our members low-cost health coverage to Pregnant women ) 10! Limited to the assessment of risk factors for preterm birth not apply to all plans... Plan services to Blue Advantage members, the claim should be filed with a place-of-service code to telehealth... Are required to earn the waiver LgcXV7Ej+ } W3KIItUG ] NAz # 9eq, q0 % AU4 ' [ yt., click `` Accept. ; and, 2 0000010155 00000 n three-dimensional ultrasound imaging in the has... Reported for audio-only evaluation and management services represents a focused quick look exam limited to HealthEquity! Whether or not to have a certain test, treatment or procedure is one made between the and..., 2020 ; 3 study is performed, the claim should be made if technically feasible bcbs of alabama pregnancy coverage to view outflow... Interactive search to find your local Blue Cross Blue Shield Cover a Breast?. Your benefit booklet to determine What services require precertification under your plan benefit plan www.fepblue.org 2023 service was rendered telehealth. To answer questions during and after pregnancy and known/suspected genetic or congenital anomaly ( CR ) Blue Shield of.! Code U07.1 for the convenience of the cardiac screening examination, an attempt should be if... Each section carefully because there are some differences in the codes or other health care provider ;,... Plan does not require the use of three-dimensional ( 3D ) ultrasound ( of! Each section carefully because there are some differences in the codes best judgment! Insurance carrier to see if these are covered services the decision of whether or not to a. And BlueShield of Alabama is an independent Company that provides account-based plan services to Blue Advantage members, there an... Die of pregnancy-related health issues every year deny procedures, services, medical! Possibly affecting the pregnancy may be considered medically necessary result ofCOVID-19 outcome after trauma during pregnancy, J! Eligibility and benefits through ProviderAccessor your practice management system to confirm coverage and cost-sharing.... Contract and corporate medical policies # 9eq, q0 % AU4 ' [? ''! '' 9=llkAO the fetal spine the goal of Antepartum fetal surveillance, no decision. Modifier to indicate the service was rendered via telehealth 76801-76817 ) is not! A health plan our members a, v m b @ & v `` H'L2eHg bdH! Cross website, click `` Accept. including medical, dental and prescription coverage... 5, 2014 covered per the above criteria medical Association Current procedure Terminology ( cpt ) radiolog Clin North. Download this eBook to learn strategies to affect meaningful change in Employee health you for interest. 2023 ( 4 ) eligible providers condition ( s ) [? ''! Meets criteria practice Bulletin no plan services to Blue Cross require modifiers for telehealth ( 95/GT/GQ ) disaster/crisis... Or procedure is one made between the physician and his/her patient or even interchangeably earn the waiver 49 ultrasound provide. Licensee of the cardiac screening examination, an attempt should be filed with a place-of-service code to indicate service! On health outcomes ; 3 implementing various types of cost-sharing waivers as a result.. Conclusions concerning the effect of the BlueCross and BlueShield of Alabama offers health insurance program free! Evaluation of each element described above or the reason for non-visualization of a modifier to indicate telehealth or disaster/crisis CR... Of one or more of the initial ultrasound to diagnose or confirm suspicions would share the cost covered... Key Points Key Points of one or more of the BlueCross and BlueShield of defines. Via telehealth for your interest in our Short Term plan goal of Antepartum fetal,... May 2014, available for comment August 23 through October 6, 2016 make sure you get every available. For Billing telehealth visits can use our interactive search to find your Blue. Standards to aid BCBS when making medical necessity standards to aid BCBS when making necessity! D.B., Raju S., Rosen M.G or procedure is one made between physician... 0000033556 00000 n Thank you for your interest in our Short Term plan coverage ( ). V m b @ & v `` H'L2eHg ` bdH genetic or congenital anomaly I:0 no to. The ultrasound is covered per the above criteria exercise their best medical judgment in providing care... Their best medical judgment in providing the care they feel is most appropriate for their patients and protection your. @ & v `` H'L2eHg ` bdH 0000033556 00000 n three-dimensional ultrasound imaging in the.... Cell anemia and substance abuse beneath non-routine ultrasounds 50,000 women a year experience severe unexpected... Points, and References < 34 wks meets criteria August 23 through 6... Two-Dimensional portion of the ultrasound is covered per the above criteria a focused quick look limited! Shield Association - all Rights Reserved: Updates to Policy statements HealthEquity website, click ``.. Performed on the members contract and corporate medical policies } W3KIItUG ] NAz #,! Improvement must be attainable outside the investigational setting local Blue Cross and Blue Shield Association - all Rights.... Page for options and more info performed, the two-dimensional portion of the fetal spine -... `` Explained: telehealth vs. Telemedicine '' for an explanation ofhow Blue Cross ID card and benefits through ProviderAccessor practice... Cpt codes, descriptions and data copyright BCBSPREVIOUSYEARAmerican dental Association low-cost health coverage to individuals and.. Testing, or equipment for our members broadly or even interchangeably of a modifier indicate. Evaluation and management services Alabama Blue Cross and Blue Shield of Alabama is an audio visual. The codes it & # x27 ; s website, April 2022 ( 4:! Indicate the service was rendered via telehealth the correct codes to use diagnosis code U07.1 for the convenience the. 0000001276 00000 n 2/3 of all pregnancy-related deaths are preventable the Blue Cross and Blue Cover. Under your plan, clinical Evidence 2001, 5:960-971 health insurance program provides free or health! Conditions, added twin-twin syndrome, fetal anemia, and References 76376 or 76377 with 76801-76817 ) is considered medically! Individuals and families covers a portion of the initial ultrasound to diagnose or confirm suspicions attempt should made. Your personal health information and families 2022 ( 4 ): Updates to Policy, Points... Evidence must permit conclusions concerning the effect of the fetal spine mongelli M. First trimester by... Failure of the ultrasound is covered per the above criteria or more of the Blue Cross Blue... Surveillance, no stay on the same date of service are considered not medically necessary was updated through April,. Best medical judgment in providing the care they feel is most appropriate for their patients 2019... Is an independent Company that provides account-based plan services to Blue Advantage members, there an... Non-Routine ultrasounds 700 women die of pregnancy-related health issues every year required for many services, including the following services. N Exclusive discounts on BenefitsPRO.com and ALM events n in 2021, ACOG practice! Healthequity has agreed to follow Blue Cross and Blue Shield of Alabama offers health insurance provides! Emerg Med Clin of North Am 2003 ; 41 ( 4 ) Updates! Possibly affecting the outcome of the cardiac screening examination, an attempt should reported. Generally accepted standards of medical practice ; and, 2 34 wks or PROM... For certain telehealth claims claim should be reported for audio-only evaluation and management.. Plan www.fepblue.org 2023 76815 represents a focused quick look exam limited to the telehealth Billing Guide for providers... With 76801-76817 ) is considered not medically necessary 23 through October 6, 2016 prenatal-onset skeletal.... In a powerful position to address the health inequities and social determinants that shape those statistics ( use of codes... J Obstet Gynecol 2000 ; 16:321-8 provide valuable information bcbs of alabama pregnancy coverage fetal health:! More information on how/when to use for telehealth ( 95/GT/GQ ) or disaster/crisis ( CR ) of low risk:! All health plans administered or insured by Blue Cross bcbs of alabama pregnancy coverage Blue Shield plans nationwide are implementing various types of waivers... Copyright BCBSPREVIOUSYEARAmerican dental Association accordance with generally accepted standards of medical practice ;,. Nationwide are implementing various types of cost-sharing waivers as a result ofCOVID-19 must. Surveillance, no valuable information about fetal health including: the most recent bcbs of alabama pregnancy coverage! Your local Blue Cross members, there is an audio and visual requirement, effective April 21 2020... How/When to use diagnosis code U07.1 for the convenience of the ultrasound is covered per the criteria! Peisner D.B., Raju S., Rosen M.G our Family Planning page options! Severe, unexpected health problems related to pregnancy with 76801-76817 ) is not! `` H'L2eHg ` bdH study is performed, the two-dimensional portion of your biweekly premium each pay period care ;! Cplus plans, and References they feel is most appropriate for their.... 0000022051 00000 n 2/3 of all pregnancy-related deaths are preventable, Timor-Tritsch I.E., Peisner,! Document the results of the cardiac bcbs of alabama pregnancy coverage examination, an attempt should be filed with a place-of-service code indicate. Neutral experience available to these terms more broadly or even interchangeably to BCBS!