Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Home Health, Home Infusion, Hospice)
Home Infusion
(continued)
Medicare Primary with
Blue Cross Secondary
11-14
Multiple Therapies
For multiple therapies in the same category done on the same date
of service as primary therapy, append the following modifiers to
the “S” code per diem:
SH- second concurrently administered infusion therapy
SJ- third or more concurrently administered therapy
Notification recommended
Notification to our Case Management department is recommended
for obstetrical patients receiving hydration therapy, tocolytic
therapy (i.e. Terbutaline) or anti-emetic infusion (i.e. Reglan or
Zofran). This serves as notification to Blue Cross that the patient
may need additional support from our staff by calling
(651) 662-5520.
Medicare Supplement policies will only coordinate with the
services that Medicare allows.
Submit the nursing claims to Medicare Part A. The claim may
crossover to Blue Cross and process with your home health
provider number. Agencies who are not certified by Medicare
A should subcontract the nursing portion of the service to
Medicare Part A certified home care agency.
Submit the drugs and supply charges to Medicare Part B. The
claim may crossover to Blue Cross and should process using
your DME provider number.
Verification of the crossover may be done on BLUELINE, or
through our secure website. If the claim is not found, attach the
Medicare EOMB and cover letter to a paper claim and submit
to Blue Cross.
For services that would be denied by Medicare, but may be
allowed by Blue Cross:
A Medicare denial is not required. Submit the claim to Blue
Cross and append the -GY modifier to each line of service.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (07/12/12)