Policy Updates Reimbursement PoliciesCommercialOctober 1, 2024

Reimbursement policy update: Modifiers 59 and XE, XP, XS, and XU: Distinct Procedural Service — Professional

Beginning with dates of service on or after January 1, 2025, Anthem will update the Modifiers 59 and XE, XP, XS, and XU: Distinct Procedural Service — Professional reimbursement policy Related Coding section to add the following:

  • J1202 will deny when reported with G0138.

In addition, the policy title was renamed from Distinct Procedural Service: Modifiers 59 and XE, XP, XS, and XU.

For specific policy details, visit the reimbursement policy page.

We are committed to finding solutions that help our care provider partners offer quality services to our members.

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.

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PUBLICATIONS: October 2024 Provider Newsletter