Beginning with dates of service on or after December 1, 2021, Anthem will implement a new reimbursement policy titled Sexually Transmitted Infections Testing. We consider Sexually Transmitted Infection (STI) testing CPT® codes 87491, 87591, and 87661 to be part of a laboratory panel grouping.

When two or more of these single test laboratory procedure codes are reported on a claim by the same provider on the same date of service, the codes will be bundled into the more comprehensive, multiple organism laboratory CPT code 87801.

 

Reimbursement will be made based on a single unit of code 87801 regardless of the units billed for a single code. The provider is required to bill for the applicable single STI CPT codes as rendered, and the comprehensive CPT code will be reimbursed. Modifiers will not override this edit.

 

For more information about this policy, visit the Reimbursement Policies page at anthem.com.  

 

1307-0921-PN-NE



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September 2021 Maine Provider News