Material Adverse Change (MAC)

 

Beginning with dates of service on or after October 1, 2022, the Empire BlueCross BlueShield (Empire) Laboratory and Venipuncture Services policy is expanded to include facility providers. The related coding section is updated to clarify coding for professional and facility providers.

 

Facility providers are not eligible for separate reimbursement for the following select
specimen-handling CPT®/HCPCS codes: 99000, 99001, H0048, P9603, and P9604. In addition, the Related Coding section I in the Bundled Services and Supplies policy is updated to remove these codes.

 

For specific policy details, visit the Reimbursement Policy page at empireblue.com/provider.

NYBCBS-COMM-001847-22



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July 2022 Newsletter