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Important Information about 2015 CPT/HCPCS Code Updates and Reimbursement Treatment – Non-Medicare Plans Only

Effective January 1, 2015

On January 1, 2015, the American Medical Association (AMA) and Centers for Medicare & Medicaid Services (CMS) will be releasing new CPT® and HCPCS codes. Many codes released as part of their updates will be accepted by WellPoint. However, the following new 2015 codes will not be eligible for reimbursement for our non-Medicare plans only:

  1. Codes G6030 – G6058 (definitive drug testing) – Reimbursement will only be provided for the applicable new 2015 CPT codes.
  2. Code G0276 (blinded procedure for lumbar stenosis, clinical trial) – This code would only be payable for Medicare patients in their CED project.
  3. Code G0472 (Hepatitis C antibody screening for high risk) – Reimbursement will only be provided for the applicable existing CPT code.
  4. Code G0473 (group behavioral obesity counseling) – Reimbursement will only be provided for the applicable existing CPT code.
  5. Code 99490 (chronic care management service) – Chronic care management services are an integral component of WellPoint’s value-based payment innovation programs.
  6. Codes 99497 – 99498 (advance care planning services) – Advance Care Planning services are an integral component of WellPoint’s value-based payment innovation programs.
  7. Code 34839 (physician planning for endograft) – Physician planning for surgery is an integral component of the surgical procedure.

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