STAY CURRENT WITH THE LATEST NEWS FROM WELLMARK® BLUE CROSS® AND BLUE SHIELD®

Information for Iowa and South Dakota physicians, hospitals and health care providers

FEATURE

New drug PA tool, NovoLogix®, launches March 1

Web updates and new tools to improve prior authorization process

ADMINISTRATION AND POLICY

ICD-10-CM coding reminders

Proper documentation for timely filing appeals

Upcoming peer-to-peer process improvements for utilization management denial decisions

EDUCATION AND RESOURCES

Recredentialing Tool has decreased administrative work for providers

The new myWellmark® has arrived

Ensure PCP status is current using E-Cred Central

PHARMACY

Vitamin D removed from ACA preventive services recommendation

Do you prescribe non-formulary medications?

FEBRUARY 2019

Visit us at Wellmark.com/BlueInk

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New drug PA tool, NovoLogix®, launches March 1

NovoLogix will streamline drug authorization process for providers

On March 1, 2019, providers will have the option to submit prior authorization requests for prescriptions online using the CVS/Caremark tool, NovoLogix. NovoLogix will bring convenience and efficiency to the drug authorization process, and can be accessed through the Utilization Management page on the secure provider portal. The link to it, labeled “Drug,” will be located at the end of the Authorization Request section:

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Please note that paper and fax drug authorization submissions will still be accepted after NovoLogix goes live. Federal Employee Program (FEP) drug authorization requests cannot be submitted through NovoLogix until July 1.

NovoLogix is an industry-leading software system that streamlines the drug authorization process for both medically and pharmacy-benefited drugs, and enables real-time PA determinations. Medically benefited drugs typically are administered by injection or infusion by MDs, DOs, or nurses. Pharmacy-benefited drugs are typically self-administered (orally, injected, or inhaled).

In addition to submitting drug authorization requests, prescribers may use the tool to:

• Review pending authorization requests

• Look up previously submitted drug authorizations

All providers will need access to the secure provider portal on Wellmark.com to use NovoLogix. Get signed up at the Register for Wellmark.com page.

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Educational resourcesWebinar

Wellmark recommends you review the NovoLogix webinar that was presented in January. It contains a thorough overview of the changes and how to navigate them.

Information about future Wellmark webinars is distributed through the Wellmark Information Notification System (WINS). If you haven’t done so, register now and subscribe to the Education and Training category.

User guide and video

A NovoLogix user guide will be posted on the Utilization Management page. This user guide will have helpful screenshots and instructions on how to easily submit drug authorizations through the tool.

In addition, a video guide on how to use NovoLogix will be posted to the Utilization Management page.

Support calls

CVS will be hosting weekly support calls throughout the month of March for providers who have questions on how to use NovoLogix. See the information listed below on how to participate.

DIAL-IN NUMBER: 1-866-750-1091

PARTICIPANT CODE: 1610637

TIMES:

• March 4, 2019, 1–2 p.m. CST

• March 11, 2019, 1–2 p.m. CST

• March 18, 2019, 1–2 p.m. CST

• March 25, 2019, 1–2 p.m. CST

See the following article for more information on the Wellmark.com provider portal web updates that will be made in conjunction with the NovoLogix launch.

MARCH 1, 2019NovoLogix goes live for providers submitting all drug authorization requests, except FEP.

JULY 1, 2019FEP drug authorization requests can be submitted through NovoLogix.

IMPORTANT NOVOLOGIX DATES

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Web updates and new tools to improve prior authorization process

A guide to the March 1 changes.

Wellmark is introducing two new prior authorization (PA) tools in 2019:

• NovoLogix will be available for drug PAs beginning March 1.

• Jiva will be available for medical PAs beginning this fall.

Paired with these changes, Wellmark will be updating the provider portal on March 1 to improve the user experience in accessing the PA tools. See below for some of the changes providers can expect to see that will help guide them to the right tool for the right purpose at the right time.

Medical Policies and Authorizations pageSome of the major changes, including rearranged links, you can expect to see on this page:

• The secure ‘Utilization Management Tool’ page will be renamed ‘Manage Authorizations,’ and will now serve as a guide for both medical and drug PAs.

• Providers will notice the change in terminology from ‘Pre-service review’ to ‘Authorization.’

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BEFORE

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Utilization Management pageThis page will still guide providers to the correct authorization tool for their situation, whether it’s drug- or medical-related. The major changes providers will notice include:

• Updated layout and a step-by-step guide.

• The name of the ‘Pharmacy Prior Authorization List’ will be changed to ‘Drug Authorization Table’ to help with consistency.

• A link to our new drug authorization tool, NovoLogix, has been added within Step 2.

• A third step has been added to make it easier for providers to check on an authorization request.

• Please note that even though these web updates go live on March 1, the medical authorization links will not send providers to the new tool, Jiva, until it goes live this fall. Until then, providers will be directed to the current Utilization Management/authorization tool.

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AFTER

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AFTER

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Pharmacy/Drug Prior Authorization pageThis page will be simplified and revised to include links to our new drug authorization tool, NovoLogix.

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AFTER

We look forward to rolling out these new tools and web updates to you in 2019, and to continually improve your experience when working with Wellmark.

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ICD-10-CM coding remindersReview the important claims information.

Wellmark implemented iCAP edits for the ICD-10-CM Excludes 1 Note and Laterality concepts in October 2018. The iCAP edits for the Excludes 1 Note and Laterality logic are coding concepts in the ICD-10-CM coding manual. The specific section that references these two concepts is the ICD-10-CM Official Guidelines for Coding and Reporting. These guidelines can be referenced here.

This information was previously communicated to providers in the June 2018 BlueInk and a webinar on Aug. 8, 2018. Additional details regarding these two concepts can be found in our Claims Filing Provider Guide on Wellmark.com.

Two concepts requiring special attention: Excludes 1 Note and LateralityPer ICD-10-CM Official Guidelines for Coding and Reporting manual, the following details are available for Excludes 1 and Laterality concepts.

Excludes 1 note

ICD-10-CM has two types of Excludes notes: Excludes 1 and Excludes 2. At this time, Wellmark will only be focusing on the Excludes 1 note. The Excludes 2 note will be addressed at a later date.

Excludes 1 note is a pure excludes note. It means “NOT CODED HERE.” It indicates mutually exclusive codes: Two conditions that cannot be reported together, such as a congenital form versus an acquired form of the same condition.

EXCLUDES 1

EXAMPLE A: The M54.5 diagnosis should never be billed on the same claim with M54.42 diagnosis. Note: This Excludes 1 note is specific to diagnosis code M54.5.

DIAGNOSIS M54.5 LOW BACK PAIN

EXCLUDES 1 low back strain (S39.012) (S39.012-S39.012S) lumbago due to intervertebral disc displacement (M51.2) (M51.2-M51.27) lumbago with sciatica (M54.4-) (M54.4-M54.42)

M54.5 Low back pain

Loin pain

Lumbago NOS

EXCLUDES 1 Low back strain (S39.012) (S39.012-S39.012S)

Lumbago due to intervertebral disc displacement (M51.2-) (M51.2-M51.27)

Lumbago with sciatica (M54.4-) (M54.4-M54.42)

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EXCLUDES 1

EXAMPLE B: The Q03.0 diagnosis should never be billed on the same claim with G91.2 diagnosis. Note: This Excludes 1 note is specific to diagnosis code range Q03; (Q03.0-Q03.9).

DIAGNOSIS Q03.0 MALFORMATIONS OF AQUEDUCT OF SYLVIUS

EXCLUDES 1 Arnold-Chiari syndrome, type II (Q07.0-Q07.03) acquired hydrocephalus (G91-G91.9) hydrocephalus due to congenital toxoplasmosis (P37.1) hydrocephalus with spina bifida (Q05.0-Q05.4)

ü4TH Q03 Congenital hydrocephalus

INCLUDES Hydrocephalus in newborn

EXCLUDES 1 Arnold-Chiari syndrome, type II (Q07.0-) (Q07.0-Q07.03)

Acquired hydrocephalus (G91.-) (G91-G91.9)

Hydrocephalus due to congenital toxoplasmosis (P37.1) (P37.1)

Hydrocephalus with spina bifida (Q05.0-Q05.4) (Q05.0-Q05.4)

Q03.0 Malformations of aqueduct of Sylvius

EXCLUDES 1

EXAMPLE C: The E78.2 diagnosis should never be billed on the same claim with E29.1 diagnosis. Note: This Excludes 1 note is specific to the “block” within Chapter 4; Metabolic Disorders (E70-E88 range).

DIAGNOSIS E78.2 MIXED HYPERLIPIDEMIA

EXCLUDES 1 androgen insensitivity syndrome (E34.5-) congenital adrenal hyperplasia (E25.0) Ehlers-Danlos syndrome (Q79.6) hemolytic anemias attributable to enzyme disorders (D55.-) Marfan’s syndrome (Q87.4) 5-alpha-reductase deficiency (E29.1)

• This Excludes 1 note is not located directly below the diagnosis (E78.2) as we typically see.

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EXCLUDES 1

EXAMPLE C continued: The E78.2 diagnosis should never be billed on the same claim with E29.1 diagnosis. Note: This Excludes 1 note is specific to the “block” within Chapter 4; Metabolic Disorders (E70-E88 range).

E78.2 Mixed hyperlipidemia

• When this occurs, reference the beginning of the chapter in your ICD-10-CM manual. — Determine which “block” diagnosis E78.2 falls into. — E70-E88 Metabolic Disorders, for this example.

Chapter 4. Endocrine, Nutritional and Metabolic Diseases (E00-E89)NOTE All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in

this chapter (i.e., E05.8, E07.0, E15-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.

EXCLUDES 1 transitory endocrine and metabolic disorders specific to newborn (P70-P74)

AHA: 2018, 2Q, 6

This chapter contains the following blocks:

E00-E07 Disorders of thyroid gland

E08-E13 Diabetes mellitus

E15-E16 Other disorders of glucose regulation and pancreatic internal secretion

E20-E35 Disorders of other endocrine system

E40-46 Malnutrition

E50-E64 Other nutritional deficiencies

E65-E68 Overweight, obesity and other hyperalimentation

E70-E88 Metabolic disorders

E89 Postprocedural endocrine and metabolic complications and disorders, not elsewhere classified

• Reference the beginning of the diagnosis “block” for the Excludes 1 note specific to your claim. Diagnosis E29.1 is displaying as a mutually exclusive diagnosis for the E70-E88 range. In other words, E29.1 should not be billed with E78.2 diagnosis.

Metabolic disorders (E70-E88)

EXCLUDES 1 Androgen insensitivity syndrome (E34.5-)

Congenital adrenal hyperplasia (E25.0)

Ehlers-Danlos syndrome (Q79.6)

Hemolytic anemias attributable to enzyme disorders (D55.-)

Marfan’s syndrome (Q87.4)

5-alpha-reuctase deficiency (E29.1)

EXCLUDES 1

EXAMPLE D: The N02.8 diagnosis should never be billed on the same claim with I12.9 diagnosis. Note: This Excludes 1 note is specific to the “block” within Chapter 14; Glomerular Diseases (N00-N08).

DIAGNOSIS N02.8 RECURRENT AND PERSISTENT HEMATURIA WITH OTHER MORPHOLOGIC CHANGES

• This Excludes 1 note is not located directly below the diagnosis (N02.8) as we typically see.

N02.8 Recurrent and persistent hematuria with other morphologic changes

• When this occurs, reference the beginning of the chapter in your ICD-10-CM manual. — Determine which “block” diagnosis N02.8 falls into. — N00-N08 Glomerular Diseases, for this example.

Chapter 14. Diseases of the Genitourinary System (N00-N99)This chapter contains the following blocks:

N00-N08 Glomerular diseases

N10-N16 Renal tubule-interstitial diseases

N17-N19 Acute kidney failure and chronic kidney disease

N20-N23 Urolithiasis

N25-N29 Other disorders of kidney and ureter

N30-N39 Other diseases of the urinary system

N40-N53 Diseases of male genital organs

N60-N65 Disorders of breast

N70-N77 Inflammatory diseases of female pelvic organs

N80-N98 Noninflammatory disorders of female genital tract

N99 Intraoperative and postprocedural complications and disorders of genitourinary system, not else-where classified

• Reference the beginning of the diagnosis “block” for the Excludes 1 note specific to your claim. Diagnosis I12 is displaying as a mutually exclusive diagnosis for the N00-N08 range. In other words, I12.9 should not be billed with N02.8 diagnosis.

Glomerular diseases (N00-N08)Code also any associated kidney failure (N17-N19)

EXCLUDES 1 Hypertensive chronic kidney disease (I12.-)

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Laterality

Laterality refers to the side of the body affected; left, right or bilateral. This coding convention was added to certain ICD-10 codes to increase specificity. Designated codes for conditions such as fractures, burns, ulcers and certain neoplasms now require documentation of the side/region of the body where the condition occurs.

• C50.511 Malignant neoplasm of lower-outer quadrant of right female breast

• H16.013 Central corneal ulcer, bilateral

• L89.022 Pressure ulcer of left elbow, stage 2

When a patient has a bilateral condition and each side is being treated, assign the “bilateral” diagnosis code, if available. It is not appropriate to bill a right and left unilateral diagnosis if there is an accurate bilateral diagnosis. However, if a bilateral code is not

available and the condition is bilateral, assign separate codes for both the left and right sides.

LATERALITY

EXAMPLE A: The patient has pain in the left shoulder.

Incorrect coding M25.519 Pain in unspecified shoulder M25.512 Pain in left shoulder M25.612 Stiffness of left shoulder, not elsewhere classified

Correct coding M25.512 Pain in left shoulder M25.612 Stiffness of left shoulder, not elsewhere classified

LATERALITY

EXAMPLE B: The patient has both a right and left artificial knee joint.

Incorrect coding Z96.651 Presence of right artificial knee joint Z96.652 Presence of left artificial knee joint

Correct coding Z96.653 Presence of artificial knee joint, bilateral

LATERALITY

EXAMPLE C — INITIAL ENCOUNTER: The patient is experiencing cataract issues in both right and left eyes.

Incorrect coding H25.11 Age-related nuclear cataract, right eye H25.12 Age-related nuclear cataract, left eye

Correct coding H25.13 Age-related nuclear cataract, bilateral

LATERALITY

EXAMPLE C — SUBSEQUENT ENCOUNTER: The patient had cataract surgery last month on his right eye and is no longer experiencing issues. The patient is now anxious to receive cataract surgery on his left eye.

Incorrect coding H25.13 Age-related nuclear cataract, bilateral

Correct coding H25.12 Age-related nuclear cataract, left eye

Note: Since the patient’s cataract issue in his right eye has resolved, the physician would no longer code for the cataract in the right eye.

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Proper documentation for timely filing appealsLearn what you should submit.

Recently, Wellmark has seen a number of appeals for timely filing denials, and we want to make sure you know what information serves as proof of timely filing and how you should submit it for review.

A few reminders:

• A Z16/acceptance report is not valid proof of timely filing.

• Providers should check their error reports from the clearinghouse. Claims are not considered timely filed if they do not make it from the clearinghouse to Wellmark.

• Outpatient services that are subsequent to inpatient admission, if not billed correctly, could lead to timely filing denial when billing issue is resolved.

• For more information, please reference the Claims Filing Section of the Wellmark Provider Guide.

As always, claims will not deny for timely filing if submitted as a clean claim within the appropriate timeframe.

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Upcoming peer-to-peer process improvements for utilization management denial decisions

We’ve improved the experience.

EFFECTIVE MARCH 1, 2019, Wellmark will be updating the peer-to-peer process providers can use after they receive a pre-service utilization management (UM) denial. These changes will improve the experience for both providers and members by shortening the time frame in which decisions are made:

• Wellmark will call each requesting provider on the day a service denial is issued.

— At this point, the requesting provider will be made aware of any missing information with their UM submission.

— The provider will also be offered the opportunity to speak to a Wellmark medical director on a peer-to-peer phone call.

• A toll-free phone number, along with three different times the provider may call will be offered.

• The provider will have one business day to confirm whether they want to move forward with the call. If they do not move forward, they will no longer be able to hold a peer-to-peer call for this UM decision.

• If the provider moves forward with the peer-to-peer call, they will contact the toll-free number during one of the offered times, then will be transferred to a Wellmark medical director to discuss the denial.

— The provider must complete the peer-to-peer call within the review timeframe that is provided in the initial verbal denial call.

• If a provider does not complete the medical director call within their designated timeframe or they choose not to exercise the option of the medical director call, the next step they can take is a provider reconsideration or an appeal.

— The timeframe to make a new request for the same member is being reduced from 180 days to 90 days.

— If there is an appeal in progress, the appeal would need to be completed before any additional review for the same service can be completed.

As a reminder the best experience for both the provider and member occurs when all necessary treatment steps are taken before a UM request is made and, if a UM request is submitted, all information is included at the time of the initial request.

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• These calls should be used to discuss the specific denial decision and impacted member.

• They should not be used to discuss criteria (medical policy or Interqual®) or Wellmark decision-making as a whole.

• If a provider has a question about Wellmark policy, they may follow the instructions on this page to contact us.

WHEN TO USE A PEER-TO-PEER CALL

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Recredentialing Tool has decreased administrative work for providers

See what the tool can do for you.

E-credentialing Central launched two and a half years ago and, since then, significant strides have been made in the providers’ ability to work efficiently with Wellmark.

Recredentialing with easeThe Recredentialing Tool was made available from the beginning of E-cred Central, and has led to a reduction in manual data entry and time-consuming administrative steps for providers. Some of its main features include:

• PRE-POPULATED APPLICATIONS When using the Recredentialing Tool to complete a recredentialing application, much of the information will already be populated for you. This saves time and reduces the likelihood for human error. The Recredentialing Tool helps efficiency and accuracy because it displays information directly from Wellmark’s provider records.

• NO PHYSICAL DOCUMENTS Recredentialing notices arrive, are completed, and signed electronically. This improvement from the previous paper-only process has led to less back-and-forth between providers and Wellmark, and recredentialing applications being submitted quicker.

Learn moreAccess educational webinars on Wellmark.com/Provider/Webinars. E-cred Central’s Recredentialing Tool is specifically highlighted in the E-Credentialing Central: Recredentialing Tool webinar.

Access the E-cred Central User Guide located in the menu after you log in for help with various tools within E-cred Central. Use the user guide as your go-to resource.

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E-CREDENTIALING CENTRAL

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The new myWellmark® has arrivedHelp your patients help themselves with the updated tool.

Your patients now have an easy-to-use, self-serve, personalized digital experience to help manage their health care spending and live a healthier life at myWellmark.com.

Health insurance is complex — myWellmark makes it easyWe know your patients can have a lot of questions about their health insurance; from coverage and in-network doctors to procedure costs and claim statuses — there can be a lot of unknowns.

The new myWellmark takes the guesswork out of health insurance and puts your patients in the driver’s seat. Save time answering common questions by pointing your patients to myWellmark. With this tool your patients will be able to:

• View detailed claims information, complete with a status tracker and cost details.

• Access benefit information specific to their own coverage.

• Find a trusted in-network doctor or provider.

• Estimate cost of care for most procedures and services before they go.

• Get helpful well-being content, news and special alerts relevant to them.

• Download a mobile app for on-the-go content and digital ID card access.

Patients can even receive their personal health insurance information at their fingertips. myWellmark is accessible on any device — including those with facial and one-touch fingerprint recognition capabilities. Learn what the new myWellmark has to offer here.

This isn’t the end of the upgrades for 2019 — it’s the beginningLaunching the new site isn’t the end of our work to making health insurance less complex for your patients, it’s the beginning. Quarterly, we’ll announce new features and improvements that will deliver even more value to you and your patients.

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Ensure PCP status is current using E-Cred CentralMake sure your information is up-to-date.

Some products that are serviced by the Wellmark Blue HMOSM network provide preventive care benefits at no member cost share only when the member’s primary care physician (PCP) or their designated backup performs the preventive examination. In addition to a preventive exam, female members with these plans may also select an OB/GYN (PCP) to provide a preventive gynecological exam at no member cost share. Members on the Wellmark Blue HMO network must receive preventive services from their PCP or OB/GYN (PCP) if the member ID card has a PCP name on it.

What providers should do If you are a provider who participates in the Wellmark Blue HMO Network, your specialty would need to reflect the PCP status in order for members with these benefit requirements to select you as their PCP and receive preventive service benefits from you.

If you determine that your specialty does not reflect the PCP designation but should, the specialty change can be updated via the Change Request Tool within E-Credentialing Central, Wellmark’s online credentialing portal.

When selecting family practice or OB/GYN as a provider type or practice focus, the tool will prompt a question asking whether or not the practitioner provides routine primary care services at that location. If the answer is yes, it will list the following requirements to be considered a PCP:

• Identify a backup provider who’s also a PCP.

• Be listed in provider directories as a PCP and practice as patients’ selected PCP under certain insurance plans.

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Vitamin D removed from ACA preventive services recommendation

Effective Jan. 1, 2019, vitamin D is no longer covered at zero cost share for adults 65 years of age and older.

Previously, the Wellmark standard Affordable Care Act (ACA) preventive services list covered over-the-counter vitamin D supplements, either brand-name or generic, for adults 65 years of age and older. However, in April 2018, the United States Preventive Services Task Force (USPSTF) changed its recommendation for vitamin D for the prevention of falls in community-dwelling older adults to a ‘D’ rating. D-rated products are not required to be covered at zero cost share.

Effective Jan. 1, 2019Wellmark has removed vitamin D supplements for adults 65 years of age and older from its standard coverage recommendation for ACA preventive services effective Jan. 1, 2019.

What does this mean?Vitamin D supplements are no longer covered at zero cost-share for members under ACA preventive benefits. Coverage has reverted to the standard benefit design and cost share. Impacted members were mailed letters in November to alert them of this change.

Please reference the updated Preventive Services list at Wellmark.com/ACAPreventive. This is the only update to Wellmark’s ACA Preventive Services list for January 2019.

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Do you prescribe non-formulary medications?Be sure to use the correct form.

Providers may need to prescribe a non-formulary medication because cost-effective alternatives are not available as part of the member’s formulary drug coverage.

We understand that exceptions may need to be made to drugs that are not covered as part of a member’s prescription drug plan. If your facility needs to prescribe a non-formulary medication, complete the Exception Request form and fax it to the number on the form.

Please note that this form is different from a prior authorization request, which allows Wellmark to verify that a prescription drug is part of a specific treatment plan and is medically necessary.

To find the current version of the most common provider forms, visit the Forms page on Wellmark.com (Provider > Communications and Resources > Forms).

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Wellmark complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATENCIÓN: Si habla español, los servicios de asistencia de idiomas se encuentran disponibles gratuitamente para usted. Comuníquese al 800-524-9242 o al (TTY: 888-781-4262).

注意：如果您说普通话，我们可免费为您提供语言协助服务。请拨打 800-524-9242 或（听障专线： 888-781-4262）。ACHTUNG: Wenn Sie deutsch sprechen, stehen Ihnen kostenlose sprachliche Assistenzdienste zur Verfügung.

Rufnummer: 800-524-9242 oder (TTY: 888-781-4262).

Wellmark Blue Cross and Blue Shield of Iowa, Wellmark Health Plan of Iowa, Inc., Wellmark Value Health Plan, Inc. and Wellmark Blue Cross and Blue Shield of South Dakota are independent licensees of the Blue Cross and Blue Shield Association.

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BlueInk is published by Wellmark Blue Cross and Blue Shield’s Marketing Department.

EDITORS: Madeline Jamison and Phil Dickinson

GRAPHIC DESIGNER: Elisa Conklin

If you would like to subscribe to BlueInk, visit Wellmark.com/DigitalBlueInk.

For other questions, visit Wellmark.com (About Wellmark > Contact Us).

Wellmark Administrators, Inc., Wellmark Blue Cross and Blue Shield of Iowa, Wellmark Health Plan of Iowa, Inc. and Wellmark Blue Cross and Blue Shield of South Dakota are independent licensees of the Blue Cross and Blue Shield Association.

Blue Cross®, Blue Shield®, the Cross® and Shield® symbols, and Blue Advantage® are registered marks and BlueInkSM is a service mark of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.

Wellmark® and myWellmark® are registered marks of Wellmark, Inc.

CVS/caremark® is a registered trademark of CVS Health Corp., an independent company that provides pharmacy services on behalf of Wellmark Blue Cross and Blue Shield. This publication contains references to brand-name prescription drugs that are trademarks or register trademarks

of pharmaceutical manufacturers not affiliated with CVS/caremark.

Current Procedural Terminology (CPT) is copyright 2018 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. CPT® is a registered trademark of the American Medical Association.

Wellmark is not providing, and does not provide, any legal advice with regard to your compliance with the requirements of the Affordable Care Act (ACA), or any other federal or state law. This document is not intended, and shall not be construed, to provide any legal advice, and may not be relied upon as such. Regulations and guidance on specific provisions of the ACA and other

federal laws have been and will continue to be provided by the U.S. Department of Health and Human Services (HHS) and/or other agencies. The information provided in this document reflects Wellmark’s understanding of the most current information and is subject to change without further notice. For specific information regarding the application of these rules to your facts,

or other compliance issues under applicable law, please consult your legal and/or tax advisors.

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