Reimbursement policy update: Distinct Procedural Service, Modifiers 59 and XE, XP, XS, and XU - Professional

Beginning with dates of service on or after October 1, 2022, Anthem will implement the following:

• 96365, 96369, 96372, 96373, 96374, 96379 will deny when reported with 78265, 78830 or 78835
• 95957 will deny when reported with 95700 on the same day
  • reference to ‘subsequent dates of service’ was removed from this code pair

 

For specific policy details, visit the reimbursement policy page at www.anthem.com/provider.

MULTI-BCBS-COMM-002032-22