Reimbursement policy update: Multiple Surgery - Facility

Anthem Blue Cross mailed letters to its participating facilities on September 24, 2021, to notify providers of a new commercial policy titled Multiple Bilateral Surgery Processing - Facility effective for dates of service on or after January 1, 2022. The policy indicated that Modifier 50 must be appended to facility claims when a bilateral procedure is performed. At this time, we have decided to remove this requirement for dates of service on or after January 1, 2022. Bilateral services should be billed as they were billed prior to January 1, 2022. The policy will be updated to remove the following:

 

• Modifier 50 must be appended to facility claims when a bilateral procedure is performed.
• When a surgical procedure code description contains the terminology “bilateral” or “unilateral or bilateral” or the code is considered inherently bilateral, modifiers LT, RT, or 50 should not be appended.

 

In addition, the policy title will be renamed to Multiple Surgery - Facility.

 

For additional information, please review the reimbursement policy at anthem.com/ca.

CABC-CM-012531-22