Blue Cross and Blue Shield of Illinois policy

Medical Policies Moving to MCG Guidelines

Medical Policies Moving to MCG Guidelines is a public Blue Cross and Blue Shield of Illinois policy (policy ADM1001.036). It lists 303 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

View the original policy (PDF) ↗

Payer
Blue Cross and Blue Shield of Illinois
Policy number
ADM1001.036
Line of business
Commercial, Medicaid
Source
medicalpolicy.hcsc.com

Codes in this policy

The CPT and HCPCS codes the policy names. A policy can name a code it excludes.

CodeOther Blue Cross and Blue Shield of Illinois policies
0063UPolicies naming 0063U
0318UPolicies naming 0318U
0322UPolicies naming 0322U
0362TPolicies naming 0362T
0373TPolicies naming 0373T
19303Policies naming 19303
20930Policies naming 20930
20936Policies naming 20936
22548Policies naming 22548
22551Policies naming 22551
22552Policies naming 22552
22554Policies naming 22554
22590Policies naming 22590
22595Policies naming 22595
22600Policies naming 22600
22840Policies naming 22840
22841Policies naming 22841
22842Policies naming 22842
22843Policies naming 22843
22844Policies naming 22844
22845Policies naming 22845
22846Policies naming 22846
22847Policies naming 22847
22853Policies naming 22853
22854Policies naming 22854
22859Policies naming 22859
27702Policies naming 27702
27703Policies naming 27703
27704Policies naming 27704
30120Policies naming 30120
30130Policies naming 30130
30140Policies naming 30140
30150Policies naming 30150
30400Policies naming 30400
30410Policies naming 30410
30420Policies naming 30420
30430Policies naming 30430
30435Policies naming 30435
30450Policies naming 30450
30520Policies naming 30520
30999Policies naming 30999
31237Policies naming 31237
31299Policies naming 31299
36516Policies naming 36516
43647Policies naming 43647
43648Policies naming 43648
43881Policies naming 43881
43882Policies naming 43882
53451Policies naming 53451
53452Policies naming 53452
53453Policies naming 53453
53454Policies naming 53454
58578Policies naming 58578
64590Policies naming 64590
64595Policies naming 64595
70450Policies naming 70450
70460Policies naming 70460
70470Policies naming 70470
70496Policies naming 70496
70551Policies naming 70551
70552Policies naming 70552
70553Policies naming 70553
76390Policies naming 76390
78600Policies naming 78600
78601Policies naming 78601
78605Policies naming 78605
78606Policies naming 78606
78608Policies naming 78608
78609Policies naming 78609
78610Policies naming 78610
78803Policies naming 78803
82016Policies naming 82016
82017Policies naming 82017
82127Policies naming 82127
82128Policies naming 82128
82131Policies naming 82131
82136Policies naming 82136
82139Policies naming 82139
82379Policies naming 82379
83015Policies naming 83015
83655Policies naming 83655
83825Policies naming 83825
83918Policies naming 83918
83919Policies naming 83919
83921Policies naming 83921
87230Policies naming 87230
88245Policies naming 88245
88248Policies naming 88248
88249Policies naming 88249
88261Policies naming 88261
88262Policies naming 88262
88263Policies naming 88263
88264Policies naming 88264
90281Policies naming 90281
90283Policies naming 90283
90785Policies naming 90785
90791Policies naming 90791
90792Policies naming 90792
90832Policies naming 90832
90833Policies naming 90833
90834Policies naming 90834
90836Policies naming 90836
90837Policies naming 90837
90838Policies naming 90838
90839Policies naming 90839
90840Policies naming 90840
90845Policies naming 90845
90846Policies naming 90846
90847Policies naming 90847
90849Policies naming 90849
90853Policies naming 90853
90863Policies naming 90863
90882Policies naming 90882
90887Policies naming 90887
90889Policies naming 90889
90899Policies naming 90899
92507Policies naming 92507
92521Policies naming 92521
92522Policies naming 92522
92523Policies naming 92523
92524Policies naming 92524
92650Policies naming 92650
92651Policies naming 92651
92652Policies naming 92652
92653Policies naming 92653
93660Policies naming 93660
95004Policies naming 95004
95018Policies naming 95018
95024Policies naming 95024
95027Policies naming 95027
95028Policies naming 95028
95044Policies naming 95044
95052Policies naming 95052
95056Policies naming 95056
95060Policies naming 95060
95065Policies naming 95065
95070Policies naming 95070
95076Policies naming 95076
95079Policies naming 95079
95700Policies naming 95700
95705Policies naming 95705
95706Policies naming 95706
95707Policies naming 95707
95708Policies naming 95708
95709Policies naming 95709
95710Policies naming 95710
95711Policies naming 95711
95712Policies naming 95712
95713Policies naming 95713
95714Policies naming 95714
95715Policies naming 95715
95716Policies naming 95716
95717Policies naming 95717
95718Policies naming 95718
95719Policies naming 95719
95720Policies naming 95720
95721Policies naming 95721
95722Policies naming 95722
95723Policies naming 95723
95724Policies naming 95724
95725Policies naming 95725
95726Policies naming 95726
95812Policies naming 95812
95813Policies naming 95813
95816Policies naming 95816
95819Policies naming 95819
95822Policies naming 95822
95925Policies naming 95925
95927Policies naming 95927
95928Policies naming 95928
95930Policies naming 95930
95954Policies naming 95954
95957Policies naming 95957
95965Policies naming 95965
95966Policies naming 95966
95967Policies naming 95967
95980Policies naming 95980
95981Policies naming 95981
95982Policies naming 95982
96000Policies naming 96000
96001Policies naming 96001
96002Policies naming 96002
96004Policies naming 96004
96105Policies naming 96105
96110Policies naming 96110
96112Policies naming 96112
96113Policies naming 96113
96116Policies naming 96116
96121Policies naming 96121
96125Policies naming 96125
96127Policies naming 96127
96130Policies naming 96130
96131Policies naming 96131
96132Policies naming 96132
96133Policies naming 96133
96136Policies naming 96136
96137Policies naming 96137
96138Policies naming 96138
96139Policies naming 96139
96146Policies naming 96146
96900Policies naming 96900
96910Policies naming 96910
96912Policies naming 96912
96913Policies naming 96913
96920Policies naming 96920
96921Policies naming 96921
96922Policies naming 96922
97151Policies naming 97151
97152Policies naming 97152
97153Policies naming 97153
97154Policies naming 97154
97155Policies naming 97155
97156Policies naming 97156
97157Policies naming 97157
97158Policies naming 97158
99183Policies naming 99183
A4575Policies naming A4575
A4638Policies naming A4638
C1767Policies naming C1767
C1776Policies naming C1776
C1778Policies naming C1778
E0641Policies naming E0641
E0642Policies naming E0642
E0643Policies naming E0643
E0691Policies naming E0691
E0692Policies naming E0692
E0693Policies naming E0693
E0694Policies naming E0694
E0765Policies naming E0765
E0830Policies naming E0830
E0840Policies naming E0840
E0849Policies naming E0849
E0850Policies naming E0850
E0856Policies naming E0856
E0860Policies naming E0860
E0890Policies naming E0890
E0900Policies naming E0900
E0920Policies naming E0920
E0930Policies naming E0930
E0941Policies naming E0941
E0942Policies naming E0942
E0944Policies naming E0944
E0946Policies naming E0946
E0947Policies naming E0947
E0948Policies naming E0948
E1902Policies naming E1902
E2120Policies naming E2120
G0151Policies naming G0151
G0152Policies naming G0152
G0153Policies naming G0153
G0157Policies naming G0157
G0158Policies naming G0158
G0159Policies naming G0159
G0160Policies naming G0160
G0161Policies naming G0161
G0176Policies naming G0176
G0177Policies naming G0177
G8539Policies naming G8539
G9012Policies naming G9012
H0031Policies naming H0031
H0032Policies naming H0032
H2012Policies naming H2012
H2013Policies naming H2013
H2014Policies naming H2014
H2019Policies naming H2019
H2020Policies naming H2020
J3490Policies naming J3490
L1834Policies naming L1834
L1840Policies naming L1840
L1844Policies naming L1844
L1845Policies naming L1845
L1846Policies naming L1846
L1860Policies naming L1860
L8680Policies naming L8680
L8685Policies naming L8685
L8686Policies naming L8686
L8687Policies naming L8687
L8688Policies naming L8688
P2031Policies naming P2031
S2120Policies naming S2120
S5108Policies naming S5108
S5110Policies naming S5110
S5111Policies naming S5111
S8035Policies naming S8035
S9128Policies naming S9128
S9129Policies naming S9129
S9131Policies naming S9131
S9355Policies naming S9355
S9480Policies naming S9480
T1023Policies naming T1023
T1024Policies naming T1024
T1025Policies naming T1025
T1026Policies naming T1026
T1027Policies naming T1027
T2013Policies naming T2013
T2020Policies naming T2020
T2022Policies naming T2022
T2023Policies naming T2023
T2024Policies naming T2024
T2025Policies naming T2025

And 3 more in the original policy.

All Blue Cross and Blue Shield of Illinois policies

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.