Blue Cross Paying for New Codes

Starting Dec. 15, 2009, Blue Cross and Blue Shield of Texas (BCBSTX) will begin reimbursing for the following performance management CPT codes: 

Category II
Description  Frequency
 0500F  Initial prenatal care visit  As appropriate
 0501F  Prenatal flow sheet documented in medical
 record by first prenatal visit
 As appropriate
 1034F  Current tobacco smoker (CAD, CAP, COPD, PV) (DM)  Annual
 1035F  Current smokeless tobacco user (e.g., chew, snuff) (PV)  Annual
  • Codes 1034F and 1035F identify tobacco users.
  • Initial prenatal care visit codes (0500F and 0501F) identify maternity cases.

Use of these codes will allow BCBSTX to:

  • Increase referrals to the Lifestyle Management Program and to Special Beginnings ® , the BCBSTX maternity program designed to offer support and education from prenatal to postpartum care.
  • Collect data about quality of care that is unavailable from claims data.

Note : When billing codes 0500F, 0501F 1034F, and 1035F, submit your usual charge; do not submit the codes with a $0 charge. Currently, BCBSTX pays $6 for each code reported. If this new program works well, BCBSTX plans to expand the code set list.

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