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Radiation Therapy and Radiology/Cardiology Imaging Services Program Updates

Horizon Blue Cross Blue Shield of New Jersey partners with eviCore healthcare to manage the radiation therapy and advanced imaging services provided to members enrolled in Horizon BCBSNJ fully-insured products, as well as to Administrative Services Only (ASO) accounts that have elected to participate in our Radiation Therapy and Radiology/Cardiology Imaging Programs.

Below are important program updates for 2017 that apply to these members.

Radiation Therapy Program

Effective August 14, 2017, certain claims for radiation therapy services will be processed based on the guidelines included in the Radiation Therapy Payment Rules documentation.

This program helps ensure that the radiation therapy services provided to our members are consistent with nationally recognized clinical standards. The Radiation Therapy Program addresses a patient’s specific disease state, stage and treatment goals, and offers clinicians the necessary flexibility to render appropriate quality care in a timely manner.

For more information about this program, visit HorizonBlue.com/radiationtherapy.

Radiology/Cardiology Imaging Program

Based on updates to program documentation, Horizon BCBSNJ will change the way certain claims for radiology/cardiology imaging services provided to members participating in this program are processed as noted below:

  • Claims for radiology/cardiology imaging services provided on and after August 14, 2017, will be processed according to the guidelines included in the Radiology/Cardiology Imaging Program Rules Bank.

    Changes in this documentation include 2017 coding updates of the American Medical Association (AMA), Current Procedural Terminology (CPT®), and Healthcare Common Procedure Coding System (HCPCS).
  • Claims for radiology/cardiology imaging services provided on and after August 14, 2017, will be processed according to the guidelines included in the Radiology/Cardiology Imaging Program Bundling Rules documentation.

    Changes in this documentation are based on the input and recommendations of eviCore healthcare.

For more information, visit HorizonBlue.com/radiologyimaging or HorizonBlue.com/cardiology.

If you have questions about the Radiation Therapy or Radiology/Cardiology Imaging Programs, please call the Institutional Services team at 1-888-666-2535, Monday through Friday, between 8 a.m. and 5 p.m., Eastern Time.

Published on: July 14, 2017, 15:03 p.m. ET
Last updated on: July 14, 2017, 15:33 p.m. ET