AdministrativeCommercialDecember 1, 2023

Outpatient system updates for 2024

As a reminder, we will update our claim editing software for outpatient facility services throughout 2024, with many updates occurring quarterly. These updates include, but are not limited to:

  • The addition of new and revised codes (for example, CPT®, HCPCS, ICD-10, modifiers, revenue codes) and associated edits.
  • Updates related to the appropriate use of various code combinations, including but not limited to, CPT/HCPCS code to revenue code, type of bill to procedure code, type of bill to CPT/HCPCS code, and CPT/HCPCS code to modifier.
  • Updates to National Correct Coding Initiative edits (NCCI) and facility outpatient hospital services medically unlikely edits (MUEs).
  • Updates to reflect coding requirements as designated by industry standard sources such as the National Uniform Billing Committee (NUBC) and the Centers for Medicare and Medicaid Services (CMS).

In Missouri (excluding 30 counties in the Kansas City area): Anthem Blue Cross and Blue Shield is the trade name of RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

MULTI-BCBS-CM-044221-23-CPN44078

PUBLICATIONS: December 2023 Provider Newsletter