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Reimbursement Policy to be Implemented: Casts, Strapping and Splints

Horizon BCBSNJ continues to enhance our claim auditing for professional claims.

Effective November 16, 2020, Horizon BCBSNJ will change the way we consider certain professional claims based on the guidelines of our reimbursement policy Casts, Strapping and Splints, which will help ensure that the processing of claims is in line with current standard business practices in regard to coding and billing rules and guidelines.

Horizon BCBSNJ will consider CPT® codes 29000-29550 and 29590-29799 for reimbursement a maximum of three times within a 90-day period for a particular patient.

This policy will apply to patients enrolled in Horizon BCBSNJ fully insured commercial plans, Horizon BCBSNJ Medicare Advantage plans and to patients enrolled in New Jersey State Health Benefits Program/School Employees’ Health Benefits Program (SHBP/SEHBP) plans. Other Administrative Services Only (ASO) employer groups may opt-in to the guidelines of this policy.

We strongly encourage you to review the content of our Casts, Strapping and Splints reimbursement policy,

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

Published on: August 17, 2020, 21:46 p.m. ET
Last updated on: April 27, 2021, 05:14 a.m. ET