Policy Bulletins
The Policy Bulletins listed below represent our catalogue of medical and claim payment policies. If you are looking for a specific type of policy, choose a category from the menu on the right. You may also use the search function in the top menu to search for policies by word or phrase.
   


Policy #
Policy Bulletin Title
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00.01.52i
Always Bundled Procedure Codes
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00.10.39l
Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus
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00.10.38a
Billing Requirements for Multiple Births for Professional Providers
00.01.59f
Care Management and Care Planning Services
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00.10.15c
Cast and Splint Applications and Associated Supplies Provided in the Office Setting
00.01.69
Consultation Services
00.10.03j
Criteria for Reimbursement of Emergency Room Services
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00.03.02aa
Diagnostic Radiology Services Included in Capitation
00.09.01f
Direct Access to Obstetrics/Gynecology (OB/GYN) Services
00.01.19d
Facility Reporting of Observation Services
00.05.01f
Guidelines for Home Care Visits Following Inpatient Maternity Stay
00.10.40d
Incident To and Non-Incident To Services Performed by Certified Registered Nurse Practitioners (CRNPs) and Physician Assistants (PAs)
00.01.47c
Inpatient Hospital Readmission
00.01.45
Intravenous (IV) Administration of Fluids as a Treatment of a Medical Condition or for the Preparation of Pharmaceuticals, Biologics, and other Substances
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00.03.07y
Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
00.01.48c
Marijuana for Medical Use
00.10.11l
Modifier 62: Two Surgeons
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00.10.17j
Modifier 66: Surgical Team
00.10.18k
Modifiers for Assistant-at-Surgery Services: 80, 81, 82, and AS
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00.01.68
Multiple Procedure Payment Reduction Guidelines for Physical, Occupational, and Speech Therapy Services
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00.01.60d
Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Services
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00.01.66b
Musculoskeletal Services (Independence)
00.01.56a
National Correct Coding Initiative (NCCI) Code Pair Edits
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00.01.44h
Never Events and Preventable Adverse Events
00.01.24h
Obsolete or Unreliable Diagnostic Tests and Medical Services
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00.03.10e
Obstetrical Ultrasounds for Members Enrolled in a Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Product
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00.03.03h
Outpatient Short-Term Rehabilitation Services Included in Capitation
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00.03.06f
Physical Medicine and Rehabilitation Services Eligible for Reimbursement Above Capitation to Physical and Occupational Therapy (PT/OT) Providers for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
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00.01.25ax
PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
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00.06.02ac
Preventive Care Services (Independence)
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00.10.36q
Radiologic Guidance of a Procedure
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00.01.18d
Reimbursement for Associated Services Performed in Conjunction with Dental Care
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00.01.61a
Reimbursement for Components of Comprehensive Laboratory Panels
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00.01.14r
Reporting and Documentation Requirements for Anesthesia Services
00.01.49c
Reporting Requirements for Drugs and Biologics
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00.10.01ab
Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers
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00.01.41b
STAT Laboratory Tests Performed in the Outpatient Hospital Setting for Health Maintenance Organization (HMO) and Point of Service (POS) Products
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00.03.09d
X-rays Associated with Fractures in the Office Setting

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Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.