• Communications

• News
• Partners In Health Update
• Provider Bulletins
• Coding Guidelines & Policy Update
• Inside IPP
• Provider Publication Cumulative Index
• Love Settlement

• Policies and Guidelines

• Claims and Billing

• Interactive Tools and Resources

• Pharmacy Information

• Resources for Patient Management

• Physician Advisory Committee

• Contact Information

Important H1N1 (Swine Flu) Information

As the H1N1 (swine flu) outbreak grows in our region, the United States, and internationally, we are working with the Pennsylvania Department of Health and the Philadelphia Department of Public Health to provide assistance with recognizing and reporting cases of swine flu.

Temporary Claims Payment Policy Change

Rapid influenza diagnostic tests can help in the diagnosis and management of patients with signs and symptoms compatible with H1N1 (swine-origin) influenza A. For this reason, effective April 27, 2009, we have added the CPT^® codes 87804 and 87400 to Policy #00.01.41: STAT Laboratory Tests Performed in the Outpatient Hospital Setting  for Health Maintenance Organization (HMO) and Point of Service (POS) products.

Facilities

For temporary billing changes regarding rapid influenza testing, see Bulletin 03-09.

Professional Providers

Until further notice, office-based rapid influenza testing (CPT^® 87804) is currently allowed as an HMO/POS billabove. There are no changes for PPO members.

Laboratory testing (CPT^® 87400) is currently also available for HMO/POS members at capitated laboratories and for PPO members at any participating network laboratory that performs that test.

Resources:

The Centers for Disease Control and Prevention: www.cdc.gov/swineflu
The Pennsylvania Department of Health: www.health.state.pa.us
The Philadelphia Department of Public Health: www.phila.gov/Health/Swine_Flu.html

Additional information about influenza