Policy Updates Reimbursement PoliciesCommercialJune 30, 2022

Reimbursement policy update: Distinct Procedural Service, Modifiers 59 and XE, XP, XS, and XU - professional

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

Material Adverse Change (MAC)

 

Beginning with dates of service on or after October 1, 2022, Empire BlueCross BlueShield will implement the following:

  • 96365, 96369, 96372, 96373, 96374, 96379 will deny when reported with 78265, 78830 or 78835.
  • 95957 will deny when reported with 95700 on the same day:
    • The reference to subsequent dates of service was removed from this code pair.

 

For specific policy details, visit the Reimbursement Policy page at empireblue.com/provider.

 

NYBCBS-COMM-001910-22-CPN1910

 

PUBLICATIONS: July 2022 Newsletter