Name of Manual - Blue Cross and Blue Shield of Minnesota

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Coding Policies and Guidelines (Public Programs) Provider Languages Geographic Coverage (By County) A-Z Friendly Languages Phone #: (763) 566-4312 Intercultural Mutual Assistance Association (IMAA) Phone #: (507) 289-5960 11-12 Afar, Albanian, Amharic, Arabic, Armenian, Azerbaijani, Basa, Belarusian, Bengali, Bosnian (Serbo- Croatian), Bulgarian, Burmese, Cebuano, Chinese (Cantonese, Mandarin, Toysanese), Czech, Danish, Dutch, Erithrian, Estonian, Ewe, Farsi, Finnish, French, Gbandi, Geo, Georgian, German, Grebo, Greek, Gujarathi, Haitian Creo, Hebrew, Hindi, Hmong, Hungarian, Idbo, Indonesian, Italian, Japanese, Kazakh, Khmer, Kirghiz, Kisi, Korean, Kpelle, Krahn, Krio, Kru, Kurdish, Latvian, Laotian, Lebanese, Liberian English, Lithuanian, Lorma, Luganda, Mandingo, Mano, Moldovan, Mongolian, Norwegian, Oromo, Polish, Portuguese, Punjabi, Pushtu, Romanian, Russian, Sarpo, Slovak, Slovenian, Somali, Soninke, Spanish, Susu, Swahili, Swedish, Tadzik, Tagalog, Tatar, Telugu, Tibetan, Tigrinya, Turkish, Turkmen, Twi, Ukranian, Urdu, Uzbek, Vietnamese, Yoruba Sign Language—NO American Sign Language, Amharic, Anuak, Arabic, ASL, Bari, Bosnian, Burmese, Cantonese, Creole, Czech, Dinka, Farsi, Filipino, French, German, Grebo, Greek, Hindi, Hmong, Homala, Indonesian, Italian, Japanese, Kamba, Kiswahili, Khmer, Korean, Krio, Kurdish, Lango, Lahu, Lao, Lao-lu, Lao-Tinh, Lokoya, Lopit, Lotoko, Luo, Mai, Mandarin, Mendi, Nuer, Oromo, Pakistani, Polish, Portuguese, Punjabai, Quechua, Romanian, Russian, Somali, Spanish, Swahili, Tagalog, Temne, Tigrinia, Thai, Turkish, Urdu, Vietnamese Sign Language---YES Anoka, Carver, Chisago, Dakota, Goodhue, Hennepin, Isanti, Kandiyohi, Le Sueur, McLeod, Mower, Olmsted, Polk, Ramsey, Rice, Scott, Sherburne, Sibley, Stearns, Washington, Wright Blue Earth, Dodge, Faribault, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steel, Wabasha, Waseca, Winona Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (02/07/12)
Community Health Workers Coding Policies and Guidelines (Public Programs) Blue Plus may reimburse for certain educational services provided by Community Health Workers (CHWs). Practitioner Enrollment Process A CHW must meet Minnesota Department of Human Services (DHS) eligibility requirements, and be enrolled through DHS before requesting enrollment with Blue Plus. DHS requirements are outlined in the MHCP Manual, which can be found at www.dhs.state.mn.us. Upon receiving a Unique Minnesota Provider Identifier (UMPI) number from DHS, a CHW may then request to be registered with Blue Plus. This process may be initiated by completing the Individual Practitioner Addition and Termination Form, which can be accessed at bluecrossmn.com. The CHW must be registered with Blue Plus before services can be billed. Member and Service Eligibility Members enrolled in the following Blue Plus plans will have benefits for services rendered by a CHW: Blue Plus Plan Alpha Prefix Blue Advantage (PMAP/GAMC) XZG MinnesotaCare XZG Minnesota Senior Care XZG Minnesota Senior Care + XZG SecureBlue SM (HMO SNP) XZS CareBlue SM (HMO SNP) XZS In order to be considered eligible for reimbursement, educational services provided by a CHW must be rendered face to face in a clinic, outpatient or home setting and be related to a medical diagnosis. In addition, the services must be supervised by a Blue Cross and Blue Shield of Minnesota or Blue Plus eligible physician, dentist, public health nurse, mental health professional, or advanced practice registered nurse (APRN). Reference the MHCP Provider Manual for additional information regarding requirements for physician orders/care plans, medical record documentation, record keeping and curriculum as they relate to CHWs. This communication can be found at www.dhs.state.mn.us. Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (02/07/12) 11-13
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Blue Cross and Blue Shield of Minne
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Recent Chapter changes: Chapter 11
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Chapter 11 - Coding Policies and Gu
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Durable Medical Equipment Date Topi
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Medical Emergency Date Topic Change
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Rehabilitative Services Date Topic
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Table of Contents Chapter 1 At Your
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Introduction Provider Policy and Pr
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How to Contact Us At Your Service P
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At Your Service Claims Address Subm
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Care Management Numbers and Address
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Care Management Numbers and Address
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Company Phone Number Address Public
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At Your Service Provider Identifica
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ID Cards At Your Service Introducti
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Electronic Commerce Overview An imp
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Remote Access Services (continued)
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Provider Communications Provider Co
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Health Plan Members have the Follow
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Provider Agreements Participation a
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Provider Agreements Responsibilitie
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Provider Agreements Provider Number
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Provider Agreements Accounting for
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Provider Agreements Carrier Replace
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Table of Contents Chapter 3 Quality
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Quality Improvement Leadership Rati
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Quality Improvement Telephone Care:
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Quality Improvement Quality of Care
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Quality Improvement Written Policie
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Quality Improvement Written Policie
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Quality Improvement Patient Safety
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Quality Improvement Medical Record
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Quality Improvement Institute for C
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Quality Improvement Quality Improve
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Quality Improvement Physical Facili
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Quality Improvement Treatment Recor
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Integrated Health Management Progra
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Integrated Health Management Provid
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Integrated Health Management Utiliz
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Integrated Health Management Medica
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Integrated Health Management Overvi
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Integrated Health Management Pre-Ce
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Integrated Health Management Decisi
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Integrated Health Management Defini
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Integrated Health Management For Lo
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Integrated Health Management Appeal
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Integrated Health Management Case &
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Integrated Health Management Diseas
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Integrated Health Management Focuse
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Integrated Health Management Specia
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Integrated Health Management Overvi
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Integrated Health Management Sample
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Health Care Options Prepaid Medical
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Health Care Options Member ID Cards
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Health Care Options Blue Cross and
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Health Care Options Double Gold Dou
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Health Care Options Medicare Basic
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Health Care Options Platinum Blue S
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Health Care Options MedicareBlue PP
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Health Care Options Inquiries and C
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Health Care Options Additional info
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Health Care Options Minnesota Senio
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Health Care Options MinnesotaCare P
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Health Care Options BlueLinkTPA Blu
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Health Care Options Delta Dental Hi
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Health Care Options Prime Therapeut
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Health Care Options Workers' Compen
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Health Care Options HICF 1500 Form
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Health Care Options Networks Blue C
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Blue Plus Member Information Introd
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Blue Plus Member Rights and Respons
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Blue Plus Member Rights and Respons
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Blue Plus Member Benefits Members
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Blue Plus Quality of Care Complaint
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Blue Plus Referral Points Remember
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Blue Plus Referral Not Required We
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Blue Plus Standing Referral Minneso
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Blue Plus Clarifications of Terms (
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Blue Plus [Date] [Name of patient]
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Blue Plus Special Member Benefits O
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Blue Plus OB/GYN Open Access Diagno
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Blue Plus OB/GYN Open Access Diagno
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BlueCard® Claim Status Inquiry ...
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BlueCard® Identifying BlueCard ®
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BlueCard® Identifying BlueCard ®
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BlueCard® BlueCard Service Claims
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BlueCard® Prior Authorization and
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BlueCard® Electronic Data Intercha
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BlueCard® Claims Processed by the
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BlueCard® Overview (continued) 3.
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BlueCard® Claim Payment Guidelines
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BlueCard® Calls from Members and O
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BlueCard® Guidelines (continued) W
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BlueCard® Types of Medicare Advant
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BlueCard® Medicare Advantage Claim
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BlueCard® Reimbursement for Medica
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Claims Filing HCPCS/ Accommodation
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Claims Filing Administrative Simpli
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Claims Filing Claims with Attachmen
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Claims Filing Claims with Coordinat
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Claims Filing Claims with Coordinat
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Claims Filing 1500 HICF Form Profes
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Claims Filing Ordering Forms and Ma
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Claims Filing Site of Service (cont
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Claims Filing Institution (837I) /F
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Claims Filing Treatment Room Blue C
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Claims Filing Single facility claim
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Claims Filing Present on Admission
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Claims Filing Medicare Crossover Bl
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Claims Filing Cancel/Void and Repla
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Claims Filing Verifying Patient Eli
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Claims Filing Basic Character Set V
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Claims Filing Rural Health Clinics
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Claims Filing Coordination of Benef
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Claims Filing TEFRA The 1982 Tax Eq
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Claims Filing Employment As defined
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Claims Filing Surgical Technicians
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Reimbursement / Reconciliation Reim
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Reimbursement / Reconciliation Comp
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Reimbursement / Reconciliation Remi
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Reimbursement / Reconciliation Ques
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Reimbursement / Reconciliation Ques
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Reimbursement / Reconciliation Acco
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Reimbursement / Reconciliation Fiel
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Appeals Provider Appeals Introducti
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Appeals Submitting Requests for Pos
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Appeals Coding Appeals (continued)
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Appeals Supporting Documentation (c
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Coding Policies and Guidelines (Cod
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Coding Policies and Guidelines (Mod
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Chapter 11 Coding Policies and Guid
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Part-time (Medically Directed) Anes
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Electroconvulsive Treatments Blue C
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Moderate (Conscious) Sedation Monit
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Coding Policies and Guidelines (Beh
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Coding Restrictions Code Restrictio
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CTSS Skills Training and Developmen
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Intensive Residential Treatment Ser
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IRTS Member Eligibility IRTS Access
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Adult Non-Residential Crisis Servic
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MH-TCM Services to Minnesota Health
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Dialectical Behavioral Therapy/DBT
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Autism Spectrum Disorder/EIBI (cont
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Autism Spectrum Disorder/EIBI (cont
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Psychiatric Consultation to Primary
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Psychiatry and Chemical Dependency
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Medication Management M0064 and 908
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Nutritional Counseling/Medical Nutr
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Practitioner Key MD = Psychiatrist
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Clinical Supervision Under Minnesot
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DIAMOND Initiative (continued) Reim
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Missed Appointments (continued) Cou
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Guidelines for Court Ordered Evalua
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Guidelines for Court Ordered Evalua
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Behavioral Health Quality Improveme
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Pre-certification and Concurrent Re
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Coding Policies and Guidelines (Den
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Prior Authorization Requirements Co
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Coding Policies and Guidelines (Dur
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Waivers and Upgraded/Deluxe DME Wai
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Hearing Aids (continued) Website Co
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Portable Oxygen Billing (continued)
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DME/Supply Internet Purchases Codin
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Coding Policies and Guidelines (Hom
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Elderly Waiver Program (continued)
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Referrals and Prior Authorization (
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Referrals and Prior Authorization (
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Adult Day Care Bath Services Coding
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Home Infusion (continued) Coding Po
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Coding Policies and Guidelines (Hom
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Rules and Regulations (continued) H
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Hospice Billing for Medicare Produc
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Coding Policies and Guidelines (Hos
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Coding Policies and Guidelines (Lab
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Papanicolaou Smears (continued) Dia
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Coding Policies and Guidelines (Mat
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Name of Manual - Blue Cross and Blue Shield of Minnesota

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