AdministrativeCommercialSeptember 1, 2023

HCPCS to revenue code alignment

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

Effective for all claims received on and after October 1, 2023, Empire BlueCross BlueShield (Empire) is updating its outpatient facility editing system to align with correct coding guidelines. For claims received on or after October 1, 2023, when revenue codes 0278, 0636, 0760, 0761, 0762, and 0769 are billed with an inappropriate HCPCS or CPT® code, they will be denied. 

For assistance with coding guidelines, please refer to CPT coding guidelines and Encoder Pro. If you believe you have received a denial in error, please follow the standard claim dispute process for Empire.

NYBCBS-CM-032417-23

PUBLICATIONS: September 2023 Provider Newsletter