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Reimbursement Policy to be Implemented: Laser Treatment of Psoriasis or Parapsoriasis

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 Laser Treatment of Psoriasis or Parasoriasis, 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.

CPT® codes 96920-96922 submitted on claims for services provided November 16, 2020 and after will be denied if submitted with a diagnosis code other than psoriasis or parapsoriasis.

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 Laser Treatment of Psoriasis or Parapsoriasis 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: August 13, 2020, 21:54 p.m. ET