11/26/2024
Using the proper Current Procedural Terminology (CPT®) Category II codes when filing claims can help streamline your administrative processes and ensure gaps in our members’ care are closed.
A coding resource for you: We developed a quick reference on CPT II and ICD-10-CM codes related to these Healthcare Effectiveness Data and Information Set (HEDIS®) measures:
- Prenatal and Postpartum Care: Learn more
- Controlling High Blood Pressure: Learn more
- Blood Pressure Control for Patients with Diabetes: Learn more
- Hemoglobin A1C Control for Patients with Diabetes: Learn more
To access the coding resource
- Sign in to Availity® Essentials. If you don’t yet have an Availity account, register here at no cost.
- Select the Payer Spaces section from the navigation menu. Then choose Blue Cross and Blue Shield of Texas.
- You can find the quick reference listed under Resources.
The material presented here is for informational/educational purposes only, is not intended to be medical advice or a definitive source for coding claims and is not a substitute for the independent medical judgment of a physician or other health care provider. Health care providers are encouraged to exercise their own independent medical judgment based upon their evaluation of their patients’ conditions and all available information, and to submit claims using the most appropriate code(s) based upon the medical record documentation and coding guidelines and reference materials. References to other third-party sources or organizations are not a representation, warranty or endorsement of such organization. The fact that a service or treatment is described in this material, is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.
CPT copyright 2023 American Medical Association. All rights reserved. CPT is a registered trademark of the AMA.
HEDIS is a registered trademark of the National Committee for Quality Assurance.