- Moved to another location
- Left a group practice
- Changed your phone number
- Changed your e-mail address
- Retired
- Any other changes to your practice information
Medical Policy updates
Approved new or revised Medical Policies and their effective dates are posted on our website the first day of each month. These policies may impact your reimbursement and your patients’ benefits. You may view all active and pending Policies or view draft Medical Policies and provide comments. While some information on new or revised Medical Policies may occasionally be published in this newsletter for your convenience, please visit our website for access to the most complete and up-to-date information. For example, due to time constraints, the following list of new or revised policies may not be complete as of the date of publication. If you have any questions about BCBSNM’s Medical Policies, please call the Office of the Medical Director at (505) 816-2093. Effective Date | Policy # | Policy Name | 05/15/12 | MED207.093 | Lymphocyte Transformation Test | 05/15/12 | RX502.033 | Ipilimumab (Yervoy) | 05/15/12 | RX501.065 | Mecasermin Recombinant (Increlex) | 06/01/12 | SUR712.004 | Intervertebral Techniques to Treat Chronic Discogenic Back Pain | 06/01/12 | SUR707.003 | Automatic Implantable Cardioverter Defibrillator (AICD) | 07/01/12 | RX501.041 | Gonadotropin-Releasing Hormone (GnRH) Agonists and Antagonists | 07/01/12 | THE801.006 | Plasmapheresis (PP) / Therapeutic Plasma Exchange (TPE) | Provider Reference Manual updates
The Blues Provider Reference Manual on our website is updated throughout the year. Any updates that have occurred so far this year are listed in the Table of Contents with Changes and Updates Preface page. Please note that these changes might not be current in the print and CD ROM versions; always refer to bcbsnm.com for the most current information. Teen Dating Abuse: Newest Be Smart. Be Well.® Topic
One in three teens will experience abuse in a dating relationship and two-thirds of them will never report it to anyone. Teens who experience abuse may be more likely to abuse drugs, drop out of school, engage in high-risk sexual behavior, act violently, and even attempt suicide. Without the proper support and intervention, young victims may find it extremely difficult to change abusive patterns as they become adults.*
View full story Medicare Part D Formulary Updates Office Staff
Claims inquiries? Call the Provider Service Unit (PSU) at 888-349-3706
Our PSU handles all provider inquiries about claims status, eligibility, benefits, and claims processing for BCBSNM members. For out-of-area claims inquiries, please call the BCBSNM BlueCard PSU at 800-222-7992. Network Services contacts and related service areas Network Services regional map ICD-10: It’s not a question of ‘if’; it’s only a matter of ‘when'
The implementation of ICD-10 will impact all segments of the health care industry. ICD-9 codes will be replaced with ICD-10-CM diagnosis codes (used on all claims), as well as ICD-10-PCS procedure codes (used for inpatient facility claims only). The original effective date for this change was October 1, 2013; however, the U.S. Department of Health and Human Services (HHS) has announced a proposed revision, changing the ICD-10 implementation date to October 1, 2014.*
View full story Lovelace Medical Center Awarded Certification as Primary Stroke Center
Lovelace Medical Center has earned The Joint Commission's Gold Seal of Approval for certification as a Primary Stroke Center after undergoing an on-site evaluation and demonstrating compliance with nationally developed standards for stroke care.
Providers who have joined or left the BCBSNM network, April 2012 BlueSalud
New Mexico Human Services Department Issues Letter of Direction #43, Coding/Procedure Options for Opioid Addiction Treatment with Suboxone or buprenorphine
In March 2012, the New Mexico Human Services Department issued a Letter of Direction to standardize the billing process for Salud! and State Coverage Insurance (SCI) providers. It also clarifies the coding and procedures to be followed during the assessment, induction, and follow up maintenance phases provided for the treatment of opioid addiction using Suboxone or buprenorphine. This change will take effect for BlueSalud members on July 1, 2012.
View full story Important reminders for submitting BlueSalud claims
When submitting claims for BlueSalud members, it is very important that you verify the member's name, ID and group numbers, and benefits information. Incorrect group numbers may cause the claim to be misrouted, causing a delay in processing.
View Full Story Ideas for articles and letters to the editor are welcome; e-mail NM_Blue_Review_Editor@bcbsnm.com. BCBSNM makes no endorsements, representations, or warranties about any products or services offered by independent third-party vendors mentioned in this newsletter. The vendors are solely responsible for the products or services offered by them. If you have any questions about the products or services mentioned in this newsletter, contact the vendor directly. | 