Reimbursement policy update: Bundled Services and Supplies - Professional (MAC)

Material adverse change

Beginning with dates of service on or after March 1, 2023, Anthem Blue Cross and Blue Shield (Anthem) will update the Bundled Services and Supplies Policy - Professional to include two new CPT codes, 87913 and K1034, as not eligible for separate reimbursement.  Specifically, Section 1 of the policy will be revised as follows to add these 2 new CPT codes:

The following codes are not eligible for reimbursement when they are reported with another service or reported as a stand-alone service:

• 87913 - Infectious agent genotype analysis by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), mutation identification in targeted region(s).
• K1034 - Provision of COVID-19 test, nonprescription self-administered and self-collected use, FDA approved, authorized, or cleared, one test count.

 

For specific policy details, visit the reimbursement policy page on anthem.com.

 

GABCBS-CM-012661-22