July 01, 2021
Blue Cross and Blue Shield of Texas has made a revision to the Clinical Payment and Coding Policy (CPCP) for Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) policy. The changes are effective July 1, 2021 or August 15, 2021 and include codes recently added by the American Medical Association (AMA) or updated by Utilization Management. These updates have been posted to the provider website.
- Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) Effective 7/1/2021 (Changes reflect codes added due to AMA code updates)
- Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) Effective 8/15/2021
Be sure to check eligibility and benefits before rendering service(s) to make sure a procedure is a covered benefit for the member. Refer to Clinical Payment and Coding Policies under Standards and Requirements on the provider website to review the current CPCPs.
If you have any questions or if you need additional information, please contact your BCBSTX Network Management Representative.
Clinical payment and coding policies are based on using healthcare professionals and industry standard guidelines. The clinical payment and coding guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers.