PRN index 2000 A Abortion pill, mifepristone (RU-486), reimbursement and code for, 12/00: 6 Access Care II, Patient Report- Central, coverage for prescription drugs, 6/00: 4 more hospitals added to, 12/00: 16 17 Act 68 and prompt payment provision, 6/00: 3 Advisory Committee on Immunization Practices (ACIP), 2/00: 4 6 Air Products and Chemicals, Inc., CustomBlue for, Allianz members, BlueCard hints for, Patient Report- Central/Eastern/Western, 2/00: 1 Anesthesia claims, problems with modifier QX and QK 12/00: 5 Anesthesia conversion factor, increase in PremierBlue and UCR, 12/00: 5 Anesthesiology modifying units, reimbursement for, 2/00: 18 20 Antepartum care, reporting and codes for, 2/00: 12 13 ASC X12 3051 to be phased out, 2/00: 3 4 Attention deficit disorder, as a psychiatric benefit, Autologous bone marrow transplantation, reimbursement for, 6/00: 7 Autopap, 6/00: 8 B Bilaminate skin substitutes for diabetic foot ulcers, reimbursement and codes for, 10/00: 3 Bio-engineered tissue for venous ulcers, reimbursement and codes for, 6/00: 7 Bladder carcinoma, reimbursement for Intron A for, 12/00: 10 BlueCard, Patient Report/Patient Newselectronic claims routing process, Central/Eastern/ Western, 6/00: 2 icon being introduced, Central/Eastern/Western, 6/00: 1 identification cards logo, new, Central/Eastern, 12/00: 13 Public School Employees Retirement System (PSERS), converts to, Central/Eastern, 12/00: 16 reminders, Central/Eastern, 4/00: 2, 8/00: 15-16 reminders, Western, 4/00: 1 BlueCHIP, expansion of benefits, 12/00: 2 3 Bone density studies, reimbursement and codes for, 2/00: 15 16 Breast cancer, autologous bone marrow and peripheral stem cell transplantations not covered, 6/00: 7 C Cardiopulmonary resuscitation, codes for, 12/00: 8 Carotid angioplasty, reimbursement and code for, 8/00: 8 Central region, Patient Report/Patient News- Allianz members, BlueCard hints for, 2/00: 1 attention deficit disorder, as a psychiatric benefit, BlueCard icon being introduced, 6/00: 1 BlueCard identification cards logos, new, 12/00: 13 BlueCard reminders, 4/00: 2, 8/00: 15-16 check identification cards to prevent payment delays, 2/00: 2 coverage for prescription drugs for Access Care II members, 6/00: 4 CustomBlue for Air Products and Chemicals, Inc., electronic claims routing process, 6/00: 2 FEP implementation of new mental health and substance abuse benefit, 12/00: 15 General Motor s Delphi Automotive Systems receives new alphabetical prefixes, 12/00: 14 15 how to eliminate delays, 4/00: 1 2 immunizations and office visits for national accounts, reimbursement for, 2/00: 1, 6/00: 1 more hospitals added to Access Care II, 12/00: 16 17 Preventive Care 2000 program, 6/00: 2 3 i
PRN index Public School Employees Retirement System (PSERS), converts to BlueCard, 12/00: 16 Childhood Immunization Insurance Act (1992), 2/00: 4 6 Claims/claim reporting tips See also Electronic claims Act 68 and prompt payment provision, 6/00: 3 check identification cards to prevent payment delays, Patient Report-Central, 2/00: 2 check status of claims before returning EOBs, 12/00: 4 FEP timely filing clarification, 2/00: 2 high-cost technology services require preapproval, 2/00: 1 how to eliminate delays, Patient Report-Central/ Eastern, 4/00: 1 2 inquiry delay notifications, 2/00: 2 oral surgery, 12/00: 3 4 provider number prevents claim delays, 6/00: 4 5 reporting tax information to avoid delays, 10/00: 1 2 Clarity Vision, refraction policies clarified, 8/00: 3 Clinical laboratories, regulations for, 6/00: 10 Clinical laboratory tests, reporting codes for, 10/00: 2 3 Connections 2000 events canceled, 2/00: 2 Consultants, appeal for professional, 4/00: 2 3 Consultations, defined, 2/00: 17 Coronary artery scanning by EBCT, reporting, 6/00: 8 Co-surgery procedures, reimbursement for, 2/00: 7 11 Critical care, reporting and codes, 2/00: 12, 6/00: 8 Cryosurgical ablation of prostate, reimbursement and codes for, 2/00: 16 CT scans, reporting and codes for, 2/00: 20 CustomBlue for Air Products and Chemicals, Inc., D Dean Foods adds PPO option, Patient Report-Eastern/ Western, 2/00: 2 Direct Access Services (DAS) Connections 2000 events canceled, 2/00: 2 LINK as an online publication, 4/00: 4 new name for, 8/00: 4 standardization of electronic health care communications, 2/00: 2 3 Drugs and biologicals allowances reduced, 2/00: 18 reporting guidelines, 2/00: 15 Durable medical equipment (DME), reimbursement for, 6/00: 7 E Eastern region, Patient Report/Patient News- Allianz members, hints for, 2/00: 1 BlueCard icon being introduced, 6/00: 1 BlueCard identification cards logo, new, 12/00: 13 BlueCard reminders, 4/00: 2, 8/00: 15 Dean Foods adds PPO option, 2/00: 2 electronic claims routing process, 6/00: 2 FEP implementation of new mental health and substance abuse benefit, 12/00: 15 General Motor s Delphi Automotive Systems receives new alphabetical prefixes, 12/00: 14 15 how to eliminate delays, 4/00: 1 2 immunizations and office visits for national accounts, reimbursement for, 2/00: 1, 6/00: 1 international identification cards, recognizing, 12/00: 13 14 Law Enforcement Health Benefits Fund (LEHB), coverage of office visits, Preventive Care 2000 program, 6/00: 2 3 Public School Employees Retirement System (PSERS), converts to BlueCard, 12/00: 16 Electrical stimulation procedures, reimbursement and codes for, 8/00: 6 Electrogastrogram, reimbursement and codes for, 10/00: 3 Electron beam CT (EBCT) scanning for coronary artery, reporting, 6/00: 8 Electronic claims BlueCard, Patient Report-Central/Eastern/Western, 6/00: 2 HealthOne, submitting, 6/00: 5 6 standardization of, 2/00: 2 3 ii
2000 Electronic data interchange (EDI) formation of, 8/00: 4 role of, 8/00: 4 6 Endovascular stent-grafts for abdominal aortic aneurysm, reimbursement and code for, 2/00: 21, 12/00: 12 Endovenous radiofrequency obliteration of greater saphenous vein, reimbursement for, 12/00: 10 Enterostomal therapy, reimbursement for, 2/00: 16 Erythropoietin (EPO), reimbursement and codes for, 8/00: 9 Explanation of Benefits (EOBs), check status of claim before returning, 12/00: 4 Explanation of Medicare Benefits (EOMBs), do not send to Blue Shield, 8/00: 3, 10/00: 2 External counterpulsation (ECP), code for, 12/00: 8 Eye examination and refraction, new codes for routine, 2/00: 21, 4/00: 9, 8/00: 3 F Federal Employee Program (FEP) implementation of new mental health and substance abuse benefit, 12/00: 15 timely filing clarification, 2/00: 2 Food and Drug Administration (FDA) reimbursement for FDA-approved pneumococcal vaccines, 4/00: 8 9 withdrawal of rotavirus vaccine, 2/00: 21 Fraud prevention, Special Investigations unit (SIU), 4/00: 1 2, 8/00: 4 Fundus photography, reimbursement and codes for, 2/00: 16 G General Motor s Delphi Automotive Systems receives new alphabetical prefixes, 12/00: 14 15 Glaucoma, scanning computerized ophthalmic diagnostic imaging for, 12/00: 7 H Health care providers, eligibility requirements for supportive, 4/00: 7 Health Insurance Portability and Accountability Act (HIPAA) (1996), standardization of electronic health care communications, 2/00: 2 3, 8/00: 4 6 HealthOne electronic claims, 6/00: 5 6 Highmark Blue Cross Blue Shield, trade name changes, 6/00: 1 2 Highmark Inc., financial stability of, 6/00: 3 4 Home infusion therapy, codes for, 8/00: 10 11 H-wave stimulation, reimbursement for, 4/00: 6 Hyperbaric oxygen therapy (HBO), code for, 8/00: 9 I Immunizations ACIP eligibility guidelines, 2/00: 4 6 FDA orders withdrawal of rotavirus vaccine, 2/00: 21 and office visits for national accounts, reimbursement for, Patient Report-Central/ Eastern/Western, 2/00: 1, 6/00: 1 reimbursement for FDA-approved pneumococcal vaccines, 4/00: 8 9 synagis, 2/00: 13 14 Infliximab (Remicade), reimbursement for, 2/00: 14 Inquiry delay notifications, 2/00: 2 Interferon alpha, reimbursement for, 4/00: 7 8 International identification cards, recognizing, 12/00: 13 14 Intravenous immune globulin (IVIG) for myasthenia gravis, reimbursement for, 12/00: 9 Intron A for bladder carcinoma, reimbursement for, 12/00: 10 Islet cell auto- and allotransplantation, reimbursement and codes for, 12/00: 11 iii
PRN index L Laser-assisted uvulopalatoplasty (LAUP), reimbursement and code for, 12/00: 11 Law Enforcement Health Benefits Fund (LEHB), coverage of office visits, LINK, online publication, 4/00: 4 Liver tumors, reimbursement for radiofrequency thermal ablation of, 8/00: 11 M Magnetic resonance angiography (MRA), reimbursement and code for, 12/00: 8 Medicare services, problems with modifier QX and QK for anesthesia claims and, 12/00: 5 Mifepristone (RU-486), reimbursement and code for, 12/00: 6 Mohs surgery and presurgical biopsies, reimbursement for, 2/00: 15 Multiple births, guidelines clarified for delivery and attendance of, 12/00: 11 Multivisceral transplantation procedure, reimbursement and codes for, 8/00: 7 8 Myasthenia gravis, reimbursement for intravenous immune globulin (IVIG) for, 12/00: 9 O Obstetrical ultrasound, reimbursement and codes for, 12/00: 8 9 Ocular photodynamic therapy, reimbursement and codes for, 10/00: 4 Office visits and immunizations for national accounts, reimbursement for, Patient Report-Central/ Eastern/Western, 2/00: 1, 6/00: 1 Oral surgery, submitting claims for, 12/00: 3 4 P Paperless Claims Express (PCE) to be phased out, 2/00: 3 4 Papnet, 6/00: 8 Pap smears, rescreenings as part of, 6/00: 8 Patient Report, integrated into main body of PRN and new name of, 8/00: 1 Pennsylvania Blue Shield financial stability of, 6/00: 3 4 trade name changes, 6/00: 1 2 Peripheral stem cell transplantation, reimbursement for, 6/00: 7 Physical therapy treatment form, No. 3861, being revised, 6/00: 11 Pneumococcal vaccines, reimbursement for FDAapproved, 4/00: 8 9 Point-of-Service (POS), Dean Foods adds, Patient Report-Eastern/Western, 2/00: 2 Positron emission tomography (PET), reimbursement and codes for, 4/00: 4 5 Preapproval, for high-cost technology services, 2/00: 1 Precertification Center, when to call, 8/00: 2 PremierBlue anesthesia conversion factor, increase in, 12/00: 5 reimbursement changes, 6/00: 6, 10/00: 2, 12/00: 6 Presurgical biopsies and Mohs surgery, reimbursement for, 2/00: 15 Preventive Care 2000 program, Patient Report-Central/ Eastern/Western, 6/00: 2 3 Prevnar, new guidelines on, 10/00: 3 4 Procedure codes for abortion pill, mifepristone (RU-486), 12/00: 6 for antepartum care, 2/00: 12 13 for bilaminate skin substitutes for diabetic foot ulcers, 10/00: 3 for bio-engineered tissue for venous ulcers, 6/00: 7 for bone density studies, 2/00: 15 16 for cardiopulmonary resuscitation, 12/00: 8 for carotid angioplasty, 8/00: 8 for critical care, 2/00: 12, 6/00: 8 for cryosurgical ablation of prostate, 2/00: 16 for CT scans, 2/00: 20 for electrical stimulation procedures, 8/00: 6 for electrogastrogram, 10/00: 3 iv
2000 for endovascular stent-grafts for abdominal aortic aneurysm, 2/00: 21, 12/00: 12 for erythropoietin, 8/00: 9 for external counterpulsation (ECP), 12/00: 8 for FDA-approved pneumococcal vaccines, 4/00: 8 9 for fundus photography, 2/00: 16 for home infusion therapy, 8/00: 10 11 for hyperbaric oxygen therapy (HBO), 8/00: 9 for islet cell auto- and allotransplantation, 12/00: 11 for laser-assisted uvulopalatoplasty (LAUP), 12/00: 11 for magnetic resonance angiography, 12/00: 8 for multivisceral transplantation procedure, 8/00: 7 8 for obstetrical ultrasound, 12/00: 8 9 for ocular photodynamic therapy, 10/00: 4 for positron emission tomography (PET), 4/00: 4 5 for radiofrequency ablation of nasal turbinates, 4/00: 8, 8/00: 8 for radiofrequency ablation of soft palate and/or tongue base, 8/00: 8 for rectal examinations, 2/00: 17 18 for routine eye examination and refraction, 2/00: 21, 4/00: 9, 8/00: 3 for scanning computerized ophthalmic diagnostic imaging, 12/00: 7 for stereotactic localization, 2/00: 15 for supplies and materials, 6/00: 8 for synagis, 2/00: 13 14, 4/00: 9 for team surgery, 6/00: 9 for thyrogen as chemotherapy service, 6/00: 9 for tumor localization of prostate, 6/00: 9 for tumor markers CA 19.9 and BTA, 8/00: 6 7 for uterine artery embolization, 2/00: 17 for xenon cerebral blood flow CT imaging, 6/00: 9 Procedures of questionable current usefulness (POQCU), procedures added to, 2/00: 21 Procedure Terminology Manual (PTM) changes in, 2/00: 22, 6/00: 10, 8/00: 12 14, 10/00: 5, 12/00: 12 mailing of, 4/00: 3 Professional consultants, appeal for, 4/00: 2 3 Prostate, reimbursement and codes for cryosurgical ablation of, 2/00: 16 for tumor localization of, 6/00: 9 Provider identification numbers assignment of new, 12/00: 1 prevent claim delays by using, 6/00: 4 5 Public School Employees Retirement System (PSERS), converts to BlueCard, 12/00: 16 Q Quality Health Care Accountability and Protection Act (1998), Act 68, 6/00: 3 R Radiofrequency ablation, reimbursement and codes of nasal turbinates, 4/00: 8, 8/00: 8 of soft palate and/or tongue base, 8/00: 8 Radiofrequency obliteration of greater saphenous vein, reimbursement for endovenous, 12/00: 10 Radiofrequency thermal ablation of liver tumors, reimbursement for, 8/00: 11 Rectal examinations, reporting and codes for, 2/00: 17 18 Reference Guide, mailing of, 12/00: 2 Refractions clarification of policies, 8/00: 3 reimbursement for, 4/00: 5 6 Reimbursement for abortion pill, mifepristone (RU-486), 12/00: 6 ACIP vaccination eligibility guidelines, 2/00: 4 6 for anesthesiology modifying units, 2/00: 18 20 for autologous bone marrow transplantation, 6/00: 7 for bilaminate skin substitutes for diabetic foot ulcers, 10/00: 3 for bio-engineered tissue for venous ulcers, 6/00: 7 for bone density studies, 2/00: 15 16 for carotid angioplasty, 8/00: 8 for clinical laboratory tests, 10/00: 2 3 for co-surgery procedures, 2/00: 7 11 for cryosurgical ablation of prostate, 2/00: 16 for drugs and biologicals, 2/00: 18 for durable medical equipment, 6/00: 7 for electrical stimulation procedures, 8/00: 6 for electrogastrogram, 10/00: 3 v
PRN index for endovascular stent-grafts for abdominal aortic aneurysm, 2/00: 21, 12/00: 12 for endovenous radiofrequency obliteration of greater saphenous vein, 12/00: 10 for enterostomal therapy, 2/00: 16 for erythropoietin, 8/00: 9 for FDA-approved pneumococcal vaccines, 4/00: 8 9 for fundus photography, 2/00: 16 for high-cost technology services, 2/00: 1 for H-wave stimulation, 4/00: 6 for immunizations and office visits for national accounts, Patient Report-Central/Eastern/ Western, 2/00: 1, 6/00: 1 for Infliximab (Remicade), 2/00: 14 for interferon alpha, 4/00: 7 8 for intravenous immune globulin for myasthenia gravis, 12/00: 9 for Intron A for bladder carcinoma, 12/00: 10 for islet cell auto- and allotransplantation, 12/00: 11 for laser-assisted uvulopalatoplasty (LAUP), 12/00: 11 for magnetic resonance angiography, 12/00: 8 for multiple births, 12/00: 11 for multivisceral transplantation procedure, 8/00: 7 8 for obstetrical ultrasound, 12/00: 8 9 for ocular photodynamic therapy, 10/00: 4 for peripheral stem cell transplantation, 6/00: 7 for positron emission tomography (PET), 4/00: 4 5 for PremierBlue and UCR, 6/00: 6, 10/00: 2, 12/00: 6 for presurgical biopsies and Mohs surgery, 2/00: 15 for Prevnar, 10/00: 3 4 for radiofrequency ablation of nasal turbinates, 4/00: 8, 8/00: 8 for radiofrequency ablation of soft palate and/or tongue base, 8/00: 8 for radiofrequency thermal ablation of liver tumors, 8/00: 11 for refractions, 4/00: 5 6 for scanning computerized ophthalmic diagnostic imaging, 12/00: 7 for screening test of visual acuity, 2/00: 16 for stereotactic localization, 2/00: 15 for supplies and materials, 6/00: 8 for synagis, 2/00: 13 14, 10/00: 4 for team surgery, 6/00: 9 for thyrogen as chemotherapy service, 6/00: 9 for tumor localization of prostate, 6/00: 9 for tumor markers CA 19.9 and BTA, 8/00: 6 7 for uterine artery embolization, 2/00: 17 for xenon cerebral blood flow CT imaging, 6/00: 9 Reporting requirements for antepartum care, 2/00: 12 13 for clinical laboratory tests, 10/00: 2 3 for coronary artery scanning by EBCT, 6/00: 8 for critical care, 2/00: 12, 6/00: 8 for CT scans, 2/00: 20 for drugs and biologicals, 2/00: 15 for HealthOne, 6/00: 5 6 for home infusion therapy, 8/00: 10 11 for hyperbaric oxygen therapy (HBO), 8/00: 9 for rectal examinations, 2/00: 17 18 rescreenings as part of pap smear, 6/00: 8 for synagis, 4/00: 9 Rotavirus vaccine, FDA orders withdrawal of, 2/00: 21 RU-486, reimbursement and code for, 12/00: 6 S Scanning computerized ophthalmic diagnostic imaging, reimbursement and codes for, 12/00: 7 Screening test of visual acuity, reimbursement for, 2/00: 16 Special Investigations unit (SIU) fraud prevention, 4/00: 1 2, 8/00: 4 website for, 8/00: 3 Stereotactic localization, reimbursement and codes for, 2/00: 15 Supplies and materials, reimbursement and code for, 6/00: 8 Synagis reimbursement and codes for, 2/00: 13 14, 10/00: 4 reporting, 4/00: 9 vi
2000 T Team surgery, defined, 6/00: 9 Thyrogen as chemotherapy service, reimbursement and code for, 6/00: 9 Training seminars, for new office personnel, 12/00: 4 5 Tumor localization of prostate, reimbursement and codes for, 6/00: 9 Tumor markers CA 19.9 and BTA, reimbursement and codes for, 8/00: 6 7 U UCR anesthesia conversion factor, increase in, 12/00: 5 reimbursement changes, 6/00: 6, 10/00: 2, 12/00: 6 Ulcers, reimbursement and codes for bio-engineered tissue for venous, 6/00: 7 Uterine artery embolization, reimbursement and codes for, 2/00: 17 V Visual acuity, reimbursement for screening test of, 2/00: 16 W Western region, Patient Report- Allianz members, hints for, 2/00: 1 BlueCard icon being introduced, 6/00: 1 BlueCard reminders, 4/00: 1 Dean Foods adds PPO option, 2/00: 2 electronic claims routing process, 6/00: 2 immunizations and office visits for national accounts, reimbursement for, 2/00: 1, 6/00: 1 Preventive Care 2000 program, 6/00: 2 3 X Xenon cerebral blood flow CT imaging, reimbursement and code for, 6/00: 9 vii
PRN index viii