Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Medical Services)
11-2
Medication Therapy Management (MTM) ....................................................................... 11-38
Oral Medication................................................................................................................. 11-40
Non-Physician Health Care Practitioners.......................................................................... 11-40
Practitioners That ARE Credentialed by Blue Cross and Issued Individual Provider
Number/NPIs..................................................................................................................... 11-41
Practitioners that are NOT Credentialed by Blue Cross But Are Issued Individual Provider
Number/NPIs..................................................................................................................... 11-42
Counseling and/or Risk Factor Reduction......................................................................... 11-42
Room or Machine Set-Up Charges.................................................................................... 11-42
Supplies in the Office ........................................................................................................ 11-42
Adjunct CPT Codes........................................................................................................... 11-42
Care Plan Oversight Services ............................................................................................ 11-42
Prolonged Physician Services............................................................................................ 11-43
Telephone Calls................................................................................................................. 11-43
Medical Team Conferences............................................................................................... 11-43
Televideo Consultations .................................................................................................... 11-43
Televideo Coverage Exceptions........................................................................................ 11-45
Unusual Travel .................................................................................................................. 11-45
Urgent Care ....................................................................................................................... 11-45
Weight Management Care................................................................................................. 11-46
Assessment Management Program for Fully Insured ....................................................... 11-51
Health Care Home (HCH)................................................................................................. 11-53
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (06/20/12)