State & FederalMedicare AdvantageMay 1, 2019

Modifier 63: Procedure performed on infants less than 4 kg: Policy 06-015

Anthem allows reimbursement for surgery on neonates and infants up to a present body weight of 4 kg when billed with Modifier 63 at 100% of the applicable fee schedule or contracted/negotiated rate. Please note, the neonate weight should be documented clearly in the report for the service. Read more.

PUBLICATIONS: Anthem May 2019 Provider News - Georgia