Aug. 25, 2025
Coding and Compensation Policies describe payment rules and methodologies for Current Procedural Terminology (CPT®) codes, Healthcare Common Procedure Coding System and ICD-10-CM coding for claims submitted as covered services. This information is a resource for our payment policies. It’s not intended to address all reimbursement-related issues. We regularly add and modify coding and compensation policy positions as part of our ongoing policy review process.
The following policies were updated:
- Neonatal Intensive Care Unit Level of Care Reimbursement and Review, effective Aug. 19, 2025
- CPCPLAB035 Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease, effective Oct. 1, 2025
- CPCPLAB044 Lyme Disease Testing, effective Oct. 1, 2025
- CPCPLAB070 Prescription Medication and Illicit Drug Testing, effective Oct. 1, 2025
- Trauma Activation Facility Services, effective Oct. 1, 2025
- CPCPLAB037 Serum Tumor Markers for Malignancies, effective Oct. 1, 2025
- CPCPLAB045 Pathogen Panel Testing, effective Oct. 1, 2025
- CPCPLAB015 Hepatitis Testing, effective Nov. 7, 2025
- CPCPLAB020 Cardiovascular Disease Risk Assessment, effective Nov. 7, 2025
- CPCPLAB037 Serum Tumor Markers for Malignancies, effective Nov. 7, 2025
- CPCPLAB045 Pathogen Panel Testing, effective Nov. 7, 2025
- CPCPLAB046 Biomarkers for Myocardial Infarction and Chronic Heart Failure, effective Nov. 7, 2025
- CPCPLAB047 Pancreatic Enzyme Testing for Acute Pancreatitis, effective Nov. 7, 2025
- CPCPLAB048 Folate Testing, effective Nov. 7, 2025
- CPCPLAB049 General Inflammation Testing, effective Nov. 7, 2025
- CPCPLAB057 Coronavirus Testing in the Outpatient Setting, effective Nov. 7, 2025
- CPCPLAB063 Identification of Microorganisms Using Nucleic Acid Probes, effective Nov. 7, 2025
For more details, refer to the revised policies in Availity® Essentials through the Plan Documents Viewer application. You can access the application in Payer Spaces for Blue Cross and Blue Shield of Montana.
CPT copyright 2024 American Medical Association. All rights reserved. CPT is a registered trademark of the AMA.
Coding and Compensation Policies are based on health care professionals’ and industry standard guidelines. The coding and compensation guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers.
The information provided does not constitute coding or legal advice. Physicians and other health care providers should use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment, and to submit claims using the most appropriate code(s) based upon the medical record documentation, coding guidelines and reference materials.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSMT. BCBSMT makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.