Commercial Code Bundling

Overview

Note: For Professional Claims Only

BlueCross BlueShield of Tennessee applies code bundling rules to evaluate the accuracy and adherence of medical claims to accepted national standards. These rules are based on code bundling guidelines such as:

bundling guidelines from sources such as but not limited to:
National Correct Coding Initiative (NCCI)
American Medical Association (AMA)
Centers for Medicare and Medicaid Services (CMS)
Medical Societies and Associations
BlueCross BlueShield of Tennessee Reimbursement Policies
BlueCross BlueShield of Tennessee clinical expertise
Reimbursement Rule Indicators and RBRVS

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Definitions

Comprehensive Code (Column 1) Generally represents the major procedure or service when reported with another code.

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Code Changes

Below, please find effective code changes:

CPT

Remittance Explanation

Surgical Procedure

Bundling Rationale

BlueCross BlueShield of Tennessee uses a clinical editing database. The clinical editing rationale supporting this database is provided here to assist you in understanding the rationale behind certain code pairs in the database.

Code pairs reported here are updated quarterly based on the following schedule.

Date Data Effective for Source

Date Change Is Applied by BCBST

January 1

April 1

April 1

July 1

July 1

October 1

October 1

January 1

 

These updates will be published on BCBST.com at least 30 days prior to the effective date of any additions, deletions or changes.

Code Bundling Rationale 2015 Q2

CPT® Codes

Code Bundling Rationale 2015 Q1

CPT® Codes

Code Bundling Rationale 2014 Q4

CPT® Codes

Code Bundling Rationale 2014 Q3

CPT® Codes

Code Bundling Rationale 2014 Q2

CPT® Codes

Code Bundling Rationale 2014 Q1

CPT® Codes

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Summary of Changes

2015

Summary of Changes for 2nd Quarter

Summary of Changes for 1st Quarter

2014

Summary of Changes for 4th Quarter

Summary of Changes for 3rd Quarter

Summary of Changes for 2nd Quarter

Summary of Changes for 1st Quarter

2013

Summary of Changes for 4th Quarter

Summary of Changes for 3rd Quarter

Summary of Changes for 2nd Quarter

Summary of Changes for 1st Quarter

2012

Summary of Changes for 1st Quarter

Summary of Changes for 2nd Quarter

Summary of Changes for 3rd Quarter

Summary of Changes for 4th Quarter

2011

Summary of Changes for 1st Quarter

Summary of Changes for 2nd Quarter

Summary of Changes for 3rd Quarter

Summary of Changes for 4th Quarter

2010

Summary of Changes for 1st Quarter

Summary of Changes for 2nd Quarter

Summary of Changes for 3rd Quarter

Summary of Changes for 4th Quarter

2009

Summary of Changes for 4th Quarter

Summary of Changes for 3rd Quarter

Summary of Changes for 2nd Quarter

Summary of Changes for 1st Quarter

2008

Summary of Changes for 4th Quarter

Summary of Changes for 3rd Quarter

Summary of Changes for 2nd Quarter

Summary of Changes for 1st Quarter

2007

Summary of Changes for 4th Quarter

Summary of Changes for 3rd Quarter

Summary of Changes for 2nd Quarter

Summary of Changes for 1st Quarter

2006

Summary of Changes for 4th Quarter

Summary of Changes for 3nd Quarter

2005:

Summary of Changes for 4th Quarter

Summary of Changes for 3nd Quarter

Summary of Changes for 2nd Quarter

Summary of Changes for 1st Quarter

 

 

CPT© is a registered trademark of the American Medical Association

 

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