Nov. 24, 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:
- Ambulatory Surgical Center Compensation Policy, effective Feb. 1, 2026
- CPCPLAB002 Cervical Cancer Screening, effective Feb. 2, 2026
- CPCPLAB004 Diabetes Mellitus Testing, effective Feb. 2, 2026
- CPCPLAB005 Prostate Biopsies, effective Feb. 2, 2026
- CPCPLAB014 Prenatal Screening, effective Feb. 2, 2026
- CPCPLAB017 Celiac Disease Testing, effective Feb. 2, 2026
- CPCPLAB024 Epithelial Cell Cytology in Breast Cancer Risk Assessment, effective Feb. 2, 2026
- CPCPLAB025 Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant, effective Feb. 2, 2026
- CPCPLAB027 Testing for Diagnosis of Active or Latent Tuberculosis, effective Feb. 2, 2026
- CPCPLAB030 In Vitro Chemoresistance and Chemosensitivity Assays, effective Feb. 2, 2026
- CPCPLAB032 Oral Cancer Screening and Testing, effective Feb. 2, 2026
- CPCPLAB033 Diagnostic Testing of Influenza, effective Feb. 2, 2026
- CPCPLAB035 Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease, effective Feb. 2, 2026
- CPCPLAB036 Serum Biomarker Testing for Multiple Sclerosis and Related Neurologic Disease, effective Feb. 2, 2026
- CPCPLAB045 Pathogen Panel Testing, effective Feb. 2, 2026
- CPCPLAB050 Urine Culture Testing for Bacteria, effective Feb. 2, 2026
- CPCPLAB051 Diagnostic Testing of Common Sexually Transmitted Infections, effective Feb. 2, 2026
- CPCPLAB052 Testing for Vector-Borne Infections, effective Feb. 2, 2026
- CPCPLAB053 Hemolytic Streptococcus Testing Feb. 2, 2026
- CPCPLAB056 Gamma-glutamyl Transferase, effective Feb. 2, 2026
- CPCPLAB059 Diagnosis of Vaginitis, effective Feb. 2, 2026
- CPCPLAB061 Testing for Alpha-1 Antitrypsin Deficiency, effective Feb. 2, 2026
- CPCPLAB065 Human Immunodeficiency Virus, effective Feb. 2, 2026
- Intraoperative Neurophysiology Monitoring (IONM) Policy, effective Jan. 15, 2026
- Modifier Compensation and Reference Policy, effective Nov. 6, 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.