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