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Medical Policy Update: Unna Boot

Effective April 16, 2018, the guidelines of our medical policy, Unna Boot, will also be applied to certain claims for services provided to patients enrolled in Horizon Blue Cross Blue Shield of New Jersey Medicare Advantage (MA) plans. Presently the guidelines of this medical policy have not been applied to claims for services provided to MA members.

We encourage you to review this policy content in our Medical Policy Manual.

Based on the guidelines of our medical policy, Unna Boot, claims for services provided on and after April 16, 2018 to members enrolled in Horizon BCBSNJ MA plans will be processed as noted below.

  • Claims that include CPT® codes 29580* will pend, regardless of the submitted diagnosis code(s), while information required to determine medical appropriateness is requested and reviewed.

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims on and after April 16, 2018.

* Please note that CPT code 29580 is not eligible for separate reimbursement if performed with CPT codes 11000, 11010, 11011, 11012, 11042, 11045, 11043, 11046, 11044 and 11047.

CPT® is a registered mark of the American Medical Association.

Published on: March 15, 2018, 12:27 p.m. ET
Last updated on: November 25, 2020, 01:00 a.m. ET