CPCP027 Inpatient Readmissions Update

Blue Cross and Blue Shield of TX has updated with minor revisions as part of its annual review the following Clinical Payment and Coding Policy (CPCP) effective January 1, 2022 and posted it to the provider website:

CPCP027 Inpatient Readmissions

Be sure to check eligibility and benefits before rendering service(s) to make sure a procedure is a covered benefit for the member and determine any prior authorization requirements. Refer to Clinical Payment and Coding Policies under Standards and Requirements on the provider website to review the current CPCPs.

Clinical payment and coding policies are based on using healthcare professionals and industry standard guidelines. The clinical payment and coding guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers.