CommercialJuly 1, 2024
Recovery room — facility editing update
Effective for all claims received on and after August 1, 2024, Anthem is updating its outpatient facility editing system to deny revenue code 0710 (recovery room services) when billed without revenue code 037X (anesthesia services), on the same claim. Per industry-standard coding resources, including the UB04 editor and the National Uniform Billing Committee (NUBC), “an anesthesia charge (revenue code category 037X) should be billed with a revenue code from category 071X, recovery room charge.”
If you believe you have received a denial in error, follow the Anthem claim dispute process.
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-061118-24-SRS60998
PUBLICATIONS: July 2024 Provider Newsletter
To view this article online:
Visit https://providernews.anthem.com/missouri/articles/recovery-room-facility-editing-update-20360
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