New COVID-19 Updates

New COVID-19 Updates

BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan continue to work diligently and actively to ensure the provider community is abreast of important information related to COVID-19 to allow for seamless services.  Below are latest updates for your convenience.

Vaccine –

BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan will cover the administration of the COVID-19 vaccine at 100 percent of the allowed amount. On Dec. 11, 2020, the following CPT codes were implemented for the vaccine administration. The vaccine itself is being funded by the government and should not be billed for payment.

Pfizer – 

  • 0001A – First Dose – 30mcg/0.3mL dosage
  • 0002A – Second Dose – 30mcg/0.3mL dosage

Moderna – 

  • 0011A – First Dose – 100 mcg/0.5mL dosage
  • 0012A – Second Dose – 100 mcg/0.5mL dosage

Telehealth –

The expansion of telehealth services will continue to be allowed until further notice.  Ongoing coverage will be continually assessed during the COVID-19 pandemic.  Telehealth delivered via non-HIPAA compliant technologies will remain non-covered.

Note: Refer to CAM 176 on the Medical Policies page of www.BlueChoiceSC.com for further guidance.

Home Health –

The expansion of telehealth services will continue to be allowed until further notice.  Ongoing coverage will be continually assessed during the COVID-19 pandemic.  Telehealth delivered via non-HIPAA compliant technologies will remain non-covered.

Note: Refer to CAM 222 on the Medical Policies page of www.BlueChoiceSC.com for further guidance.

Testing: CPT and Diagnosis Codes –

On Dec. 11, 2020, additional CPT and diagnosis codes for testing were added to the COVID-19 coverage.  The codes include:

  • CPT Codes: 86408, 86409 and 87428
  • Diagnosis Codes: J12.82, M35.81, M35.89, Z11.52, Z20.822 and Z86.16

Note: Refer to CAM 244 on the Medical Policies page of www.BlueChoiceSC.com for further guidance.

Monoclonal Antibody Infusion Therapy –

BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan will cover the administration of monoclonal antibody infusion therapy drugs (Bamlanivimab and Casirivimab/Imdevimab) when filed with an appropriate COVID-19 diagnosis code at 100% of the allowed amount.  The drugs themselves are being funded by the government and should not be billed for payment.  This includes the following CPT codes:

Bamlanivimab – 

  • M0239

Casirivimab/Imdevimab – 

  • M0243

Note: At this time, prior authorization is not required.

If you have any questions, contact Provider Education at Provider.Education@bcbssc.com or reach out to your Provider Education Representative for further assistance.