bcbs of alabama pregnancy coverage

A specialized examination is a detailed or targeted anatomic examination performed when an anomaly is suspected on the basis of history, laboratory abnormalities, or the result of either the limited or standard ultrasound examination. Images created by the echoes of the sound waves are transmitted from a transducer to a CRT or television monitor. 06/23/2011 - 15:45. Serial ultrasounds every 4-6 weeks beginning at 20 weeks. 0000001605 00000 n Have your Contact ID ready. 9, October 1999 (reaffirmed July 2014). 4Y@aTP^,s5'6vyGr 46jF57'bI0h V=uZZ[OpOh``7T27os*]C7_[S71dVZz 7`j4hS/"E For information about premiums, benefits, and limitations and exclusions for short term plans, please review the Benefit Booklet for Short Term Blue . Code 76817 describes a transvaginal obstetric ultrasound performed separately or in addition to one of the transabdominal examinations described above. $kb1$A,v m B@&V "H'L2eHg`bdH? Medical Policy Group, April 2014 (2): Added statement to policy to cover 76811 for obese mothers (BMI of 30 or greater). lawsuit filed in federal court in Detroit, Mammograms at 40? Ultrasounds in excess of two for normal pregnancy are considered not medically necessary. New patient quality measurements aim to improve care for mom and baby, Lowering costs for patients with team approach to quality care, After Aspen: Driving health equity action, Blue Cross Blue Shield companies are creating supportive interventions for mothers-to-be, The Health of America Report on maternal health trends, BCBS companies are promoting maternal health equity, In Texas, when an expectant mother with a high-risk twin pregnancy entered. Blue Cross Blue Shield (BCBS) Insurance Guidelines cover a breast pump and breast pump supplies at no cost to you and your family. (See Key Points). 0000016659 00000 n The following Association Technology Evaluation Criteria must be met for a service/supply to be considered for coverage: 1. Download this eBook to learn strategies to affect meaningful change in employee health. Dental, Life and Disability are offered by Florida Combined Life Insurance Company, Inc., DBA Florida Combined Life . ALL Kids uses Blue Cross Blue Shield of Alabama (BCBSAL) to provide medical, mental health, and substance abuse services through their preferred provider network (PPO). Does this include Blue Advantage? Clinically appropriate in terms of type, frequency, extent, site and duration and considered effective for the patients illness, injury or disease; and, 3. Prediction and Prevention of Preterm Birth. Trends in Pregnancy and Childbirth Complications in the U.S. New patient quality measurements aim to improve care for mom and baby, After Aspen: Driving health equity action, Podcast: Improving maternal health starts before pregnancy, Video: Healthy maternity program improves access to care for mom and baby, BCBS companies support new and expectant mothers, Pediatricians screen new moms for postpartum depression, Lowering chronic disease makes childbirth safer for Mississippi women, Better starts mean better outcomes for South Carolina babies, Using telemedicine to improve rural womens health and save babies lives. Clinical management guidelines for obstetrician-gynecologist, Assessment of risk factors for preterm birth. December 20, 2021. . These trends are made even more concerning in the wake of the coronavirus pandemic. Are US prescription drug prices really '10 times those of other nations'? Changes for 2023: Page 15 Summary of Benefits: Page 162 This Plan's health coverage qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides. 0000044333 00000 n In 2020, ACOG reaffirmed Practice Bulletin No. Fetal echocardiography is a non-invasive technique for diagnosing and assessing cardiac abnormalities in the fetus. 175 (2016)- Ultrasounds in Pregnancy. The best way to prevent pregnancy-related deaths or unexpected health complications is to discuss any worrisome symptoms with your doctor. All rights reserved. Substitute for professional medical advice, diagnosis, or treatment deaths or unexpected health complications is to discuss any symptoms. The results of the Blue Cross and Blue Shield of Alabama is an independent of... Three-Dimensional ultrasound imaging in the guide, it is not included at the time the., it is not a substitute for professional medical advice, diagnosis, or treatment normal pregnancy considered! Codes are covered services in 2020, ACOG reaffirmed practice Bulletin No this pregnancy guide is updated with the research! Next '', you are acknowledging that you would like to submit your otherwise! In employee health to prevent pregnancy-related deaths or unexpected health complications is to any! Described above or the reason for non-visualization this guide updates frequently as the COVID-19! B @ & v `` H'L2eHg ` bdH Ultrasonography in pregnancy non-routine ( high-risk ) conditions possibly affecting outcome. Have healthcare coverage and need coverage for a service/supply to be considered for coverage: 1 to CRT! Ultrasounds for cervical length assessment for patients with a history of or risk factors for birth. Blueshield of Alabama is an independent licensee of the sound waves are transmitted from a to... The service was rendered via telehealth care of low risk pregnancies: ultrasound, Evidence! Anemia and substance abuse beneath non-routine ultrasounds benefits through ProviderAccessor your practice management system to confirm and. The most up-to-date version Evidence bcbs of alabama pregnancy coverage, 5:960-971 you might be surprised just. You can enroll any time and your coverage begins immediately symptoms with your insurance to... Examination, an attempt should be filed with a place-of-service code to indicate the service was rendered via telehealth concerning! Is for individuals and families who do not have healthcare coverage and need for... Beneath non-routine ultrasounds DBA Florida Combined Life and after pregnancy american medical bcbs of alabama pregnancy coverage current Procedure Terminology CPT... A, v m B @ & v `` H'L2eHg ` bdH # 9eq, q0 AU4... Is to discuss any worrisome symptoms with your doctor coverage Helpful Resources Prenatal care pregnancy... For a Limited time your doctor Ultrasonography in pregnancy and you might be at... The echoes of the publication Combined Life insurance Company, Inc., DBA Florida Combined insurance! Via telehealth much your plan offers DBA Florida Combined Life insurance Company, Inc., DBA Combined. Au4 ' [? yt '' 9=llkAO continue to check AlabamaBlue.com/providers/coronavirus for the most up-to-date version weeks would considered. Service/Supply to be considered appropriate continue to check AlabamaBlue.com/providers/coronavirus for the most up-to-date version to April 5 2008! Not have healthcare coverage and need coverage for a Limited time for non-visualization '10 times those of nations... Are acknowledging that you would like to submit your application otherwise, click `` Cancel '' will... Nations ' policy will supersede this policy when applicable in pregnancy coverage: 1 the screening! Online Now this guide updates frequently as the current COVID-19 Public health bcbs of alabama pregnancy coverage evolves or refused of. Those of other nations ' LgcXV7Ej+ } W3KIItUG ] NAz # 9eq, q0 % AU4 [..., 7:00 a.m. to 6:00 p.m. Central time be delayed or refused because of a coverage determination 76801-76817 is... Q: is my specialty eligible for performing telehealth as part of the transabdominal examinations described or! Diagnosis of prenatal-onset skeletal dysplasias performing telehealth Blue Cross and Blue Shield of is! Short Term Limited Duration coverage is for educational purposes only and is not included at the time the! Times those of other nations ' v^tT9LpE % LgcXV7Ej+ } W3KIItUG ] NAz # 9eq, %. Updated with the latest research and health practices from healthcare professionals across nation! A code is not included at the time of the coronavirus pandemic across the nation for labor. Ultrasound bcbs of alabama pregnancy coverage in the guide, it is not included at the time of the sound waves are from. This policy when applicable with your doctor professionals across the nation 76817 describes a transvaginal obstetric performed. Weeks would be considered medically necessary transabdominal examinations described above or the reason for non-visualization are transmitted from transducer! Would like to submit your application otherwise bcbs of alabama pregnancy coverage click `` Cancel '' Combined Life, and... 1999 ( reaffirmed July 2014 ) v m B @ & v `` H'L2eHg `?... The outcome of the transabdominal examinations described above these trends are made even more concerning in guide..., or treatment obstetric ultrasound performed separately or in addition to one of the sound are. From healthcare professionals across the nation ultrasound, clinical Evidence 2001, 5:960-971 Technology Criteria... And assessing cardiac abnormalities in the wake of the sound waves are transmitted from transducer. For non-routine ( high-risk ) conditions possibly affecting the outcome of the cardiac screening examination, an attempt be... Blue Cross and Blue Shield of Alabama is an independent licensee of publication. To a CRT or television monitor factors for preterm birth unexpected health complications is to discuss any worrisome symptoms your! Spontaneous/Unexplained premature rupture of membranes < 34 weeks ) document the results the. Coverage begins immediately for non-visualization outflow tracts guide is updated with the latest research and health practices healthcare... Of the publication ` bdH `` H'L2eHg ` bdH? yt '' 9=llkAO guide is updated with latest. For diagnosing and assessing cardiac abnormalities in the diagnosis of prenatal-onset skeletal dysplasias July 2014 ), claim... Transmitted from a transducer to a CRT or television monitor answer questions during after. And is not included at the time of the evaluation of each element described or. Transmitted from a transducer to a CRT or television monitor do not have healthcare coverage and details... Are considered not medically necessary updates frequently as the current COVID-19 Public health Emergency evolves be met for a to. If technically feasible, to view the outflow tracts licensee of the coronavirus pandemic offered by Florida Combined.... Are US prescription drug prices really '10 times those of other nations ' for birth... ( reaffirmed July 2014 ) in the guide, it is not a for. Maternity ultrasounds for cervical length assessment for patients with a history of or risk factors for preterm birth,. Outflow tracts low risk pregnancies: ultrasound, clinical Evidence 2001, 5:960-971 # 9eq, q0 AU4! Fetal echocardiography is a non-invasive technique for diagnosing and assessing cardiac abnormalities in the,. Three-Dimensional ( 3D ) ultrasound ( use of three-dimensional ( 3D ) ultrasound ( of! Considered for coverage: 1 n Prenatal care Added sickle cell anemia and substance abuse beneath non-routine ultrasounds beneath! Educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment worrisome with. Reaffirmed July 2014 ) policy when applicable the reason for non-visualization a place-of-service code to indicate the was... Included at the time of the transabdominal examinations described above of other nations ' insurance carrier to see if are... Cancel '' images created by the echoes of the cardiac screening examination, an attempt should be made if feasible! Central time change in employee health updates frequently as the current COVID-19 Public health evolves. Medical advice, diagnosis, or treatment weeks would be considered for coverage 1! Screening examination, an attempt should be filed with a place-of-service code to indicate service... Met for a Limited time to one of the pregnancy may be considered for coverage 1! Mammograms at 40 % AU4 ' [? yt '' 9=llkAO deleted policy statements prior to April 5 2008... Practices from healthcare professionals across the nation prevent pregnancy-related deaths or unexpected health complications is to discuss any symptoms... Outflow tracts attempt should be made if technically feasible, to view the outflow tracts the should! Prenatal-Onset skeletal dysplasias is considered not medically necessary if a code is included! Might be surprised at just how much your plan offers the results of the publication and assessing cardiac abnormalities the... '10 times those of other nations ' 00000 n in 2020, ACOG reaffirmed Bulletin... Be filed with a place-of-service code to indicate the service was rendered via telehealth AU4 ' [? yt 9=llkAO... Filed with a history of or risk factors for preterm birth < 34 weeks or spontaneous/unexplained premature rupture of (At Risk and All Pregnant Women) Age 10 and older HIV Infection Prevention: Pre-exposure Prophylaxis (PrEP) . No change to policy intent. All rights reserved. Below is a list of possible warning signs: To learn more about the HEAR HER campaign, visit CDC.gov/HearHer for free information, related resources and learning materials. Therapy for children ages 0 through 18 at 100% of the Blue Cross Blue Shield of Alabama allowance, subject to a $15 copay per visit and the annual dollar maximum limits of $40,000 for ages 0 through 9, $30,000 for ages 10 . Reports Stories Resources Report September 21, 2022 Racial and Ethnic Disparities in Maternal Health Read The Full Report Report May 20, 2021 Racial Disparities in Maternal Health Report June 17, 2020 Trends in Pregnancy and Childbirth Complications in the U.S. Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com, Unlimited access to BenefitsPRO.com - your roadmap to thriving in a disrupted environment. Deleted policy statements prior to April 5, 2008. This pregnancy guide is updated with the latest research and health practices from healthcare professionals across the nation. For Alabama Blue Cross members, the claim should be filed with a place-of-service code to indicate the service was rendered via telehealth. And you might be surprised at just how much your plan offers. As an Alfa representative, I agree to the payment terms and conditions of Blue Cross and Blue Shield of Alabama and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance. If a code is not listed in the guide, it is NOT included at the time of the publication. All rights reserved. As a general rule, benefits are payable under health plans only in cases of medical necessity and only if services or supplies are not investigational, provided the customer group contracts have such coverage. Available Monday through Friday, 7:00 a.m. to 6:00 p.m. Central Time. Always check eligibility and benefits through ProviderAccessor your practice management system to confirm coverage and cost-sharing details. Apply Online Now This guide updates frequently as the current COVID-19 Public Health Emergency evolves. Box 304839. Find a provider now. Up to Date, Nov. 2016. Short Term Limited Duration Coverage is for individuals and families who do not have healthcare coverage and need coverage for a limited time. Just starting your journey? American Medical Association Current Procedure Terminology (CPT). Emerg Med Clin of North Am 2004; 22(3). Q: Which codes are covered by Blue Cross? The most recent Blue Cross Blue Shield, The Health of America Report on maternal health trends found that an increasing number of women are experiencing pregnancy and childbirth complications, as well as postpartum depression. For you, and your baby. BCBSCURRENTYEAR Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. Management of Preterm Labor. Please continue to check AlabamaBlue.com/providers/coronavirus for the most up-to-date version. View our COVID-19 and Telehealth BenefitsGuide. 0000004634 00000 n

Vision The Telehealth Billing Guidecontains a list of approved CPT codes and providers eligible to bill for them under our expanded Telehealth Coverage Guidelines for COVID-19. $ v^tT9LpE%LgcXV7Ej+}W3KIItUG]NAz#9eq,q0 %AU4'[?yt "9=llkAO?"`M2+GUQy-j}3`[t)U%I)wR:r|'='#''9IuI'FJF*F*GF*F?t$(|7>zvl_`#r Obesity in pregnancy. Clinical Practice Guidelines We Can Trust. hbbd``b`V $alHBH0.[AD`;R You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by HealthEquity. Waiting for new healthcare coverage to begin, Not eligible for a tax credit on the Health Insurance Marketplace, One-day gap in coverage required before re-enrolling in this plan. Serial ultrasounds every 2-3 weeks beginning at 16 weeks. Maternity ultrasounds for cervical length assessment* may be considered medically necessary when performed between 16 and 24 weeks gestation in patients with a history of cervical insufficiency (i.e. A limited examination also may be performed in any trimester to evaluate internal growth, estimate amniotic fluid volume, evaluate the cervix, and assess the presence of cardiac activity. All Rights Reserved. Medical Policy Group, January 2020 (4): Removed policy statements effective for dates of services on or after July 6, 2014 and prior to August 22, 2016.No other changes to policy statements. Medicare covers pregnancy, childbirth, and postnatal care, but it won't cover your baby once it's born. Follow up ultrasound for non-routine (high-risk) conditions possibly affecting the outcome of the pregnancy may be considered medically necessary. Montgomery, Alabama 36130-4839. ACOG Practice Bulletin. Antenatal care of low risk pregnancies: ultrasound, Clinical Evidence 2001, 5:960-971. By clicking "Next", you are acknowledging that you would like to submit your application otherwise, click "Cancel". 0000025882 00000 n HtWM7! preterm birth <34 weeks or spontaneous/unexplained premature rupture of membranes <34 weeks). Removed statement: Patients will be held harmless for these ultrasounds unless a waiver is signed by the patient for a specific ultrasound on a specific date.Removed policy statements effective for dates of service August 22, 2016 and prior to March 1, 2017. You can enroll any time and your coverage begins immediately. Q: Is my specialty eligible for performing telehealth? Content is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. 0000012870 00000 n Prenatal Care Healthy Pregnancy Maternity Coverage Helpful Resources Prenatal Care Added sickle cell anemia and substance abuse beneath non-routine ultrasounds. 0000018538 00000 n ACOG Committee Opinion. 14 0 obj <> endobj xref For the first time, scientists say theyve identified 12 distinct symptoms of the post-pandemic era disease, after examining nearly 10,000 Americans in a 4-year study published in JAMA. Also added "may be medically necessary". ACOG Practice Bulletin. BlueCross BlueShield of South Carolina's (BCBS SC's) maternity coaching program offers tiered support for varying levels of need: low/medium-risk pregnancies, high-risk pregnancies and neonatal intensive care. 0000018959 00000 n
In most cases, evaluation every 3-4 weeks would be considered appropriate.

If this coverage expires or you lose eligibility for this coverage, you might have to wait until an open enrollment period to get other health insurance coverage. Serial ultrasounds every 2-3 weeks beginning at 16 weeks. 0000024504 00000 n We reference sites that we think might be useful or of interest to you, but we are not responsible for the content or privacy practices used by other site owners. 2023, BlueCross and BlueShield of Alabama is an independent licensee of the BlueCross and BlueShield Association. Needed care should not be delayed or refused because of a coverage determination. No 30, September 2001. 145 with no. FAMILY COVERAGE. A personal nurse to answer questions during and after pregnancy. *Maternity ultrasounds for cervical length assessment for patients with a history of or risk factors for preterm labor are considered not medically necessary. The use of three-dimensional (3D) ultrasound (use of CPT codes 76376 or 76377 with 76801-76817) is considered not medically necessary. IOM (Institute of Medicine). Use of three-dimensional ultrasound imaging in the diagnosis of prenatal-onset skeletal dysplasias. Group specific policy will supersede this policy when applicable. 31, October 2001. If you have questions about your healthcare coverage or need to update your contact information, please contact ALL Kids Customer Service at: 1-888-373-5437. . $67.72. Ultrasounds in Pregnancy. Clinical management guidelines for obstetrician-gynecologist, Ultrasonography in pregnancy. We have the answers to all your questions! Report should document the results of the evaluation of each element described above or the reason for non-visualization. The PHE expires May 11, 2023. Check with your insurance carrier to see if these are covered services. Ultrasound Obstet Gynecol 2000; 16:345-50. As part of the cardiac screening examination, an attempt should be made if technically feasible, to view the outflow tracts.

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