Effective July 1, 2016, Blue Cross & Blue Shield of Mississippi (BCBSMS) has implemented new medical and coding policies for Breast Pathology, GI Pathology, Prostate Pathology, Component Billing of Clinical Pathology and IHC Pathology.
A brief description of each policy is listed below. It is important that you thoroughly review each policy with your clinical and administrative staff to ensure they understand the new guidelines prior to performing and billing these services.
The following is directly from the Blue Cross of Mississippi Provider Web Site:
Component Billing of Clinical Pathology
As an adjunct to surgical pathology tissue exams, pathologists use immunohistochemistry (IHC) tests as an aid in diagnosing certain cancers by identifying characteristics proteins. In addition, IHC can also help determine appropriate treatment regimen for certain cancers.
Understandably, the Mississippi Association of Pathologists (MAP) is deeply concerned with the extremely short notification time as well as the content and basis for such policies. Not surprisingly, the MAP has contacted BCBSMS to enter into discussions about the nature of these new policies. It is imperative that all Pathologists consider conveying your concerns to BCBSMS based on your interpretation of these policies.
Verdugo Hills, CA